Provider First Line Business Practice Location Address:
539 GREEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-834-1122
Provider Business Practice Location Address Fax Number:
724-838-8112
Provider Enumeration Date:
01/31/2006