Provider First Line Business Practice Location Address:
2656 ELLWOOD RD
Provider Second Line Business Practice Location Address:
LAWRENCE VILLAGE PLAZA
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-6282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-652-6430
Provider Business Practice Location Address Fax Number:
724-652-4552
Provider Enumeration Date:
04/23/2007