Provider First Line Business Practice Location Address:
87 E MAIDEN ST
Provider Second Line Business Practice Location Address:
SUITE 31
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-4964
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-3444
Provider Business Practice Location Address Fax Number:
724-222-2189
Provider Enumeration Date:
04/24/2006