Provider First Line Business Practice Location Address:
7160 MASON DIXON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEYERSDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15552-7288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-972-6678
Provider Business Practice Location Address Fax Number:
814-634-7289
Provider Enumeration Date:
10/10/2019