Provider First Line Business Practice Location Address:
400 LOCUST AVE STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-3397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-228-1028
Provider Business Practice Location Address Fax Number:
888-506-6237
Provider Enumeration Date:
07/08/2005