Provider First Line Business Practice Location Address:
801 N GREENGATE RD
Provider Second Line Business Practice Location Address:
STE 310
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-7460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-853-2355
Provider Business Practice Location Address Fax Number:
724-853-0935
Provider Enumeration Date:
10/26/2005