Provider First Line Business Practice Location Address:
132 HOWE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COAL CENTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15423-1138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-880-9205
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2023