Provider First Line Business Practice Location Address:
522 W NEWTON ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-2820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-834-8113
Provider Business Practice Location Address Fax Number:
724-832-7496
Provider Enumeration Date:
10/18/2006