Provider First Line Business Practice Location Address:
3 KENSINGTON SQUARE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
NEW KENSINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-335-9733
Provider Business Practice Location Address Fax Number:
724-335-0734
Provider Enumeration Date:
12/06/2012