Provider First Line Business Practice Location Address:
9239 ROUTE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNION CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16438-9727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-438-2020
Provider Business Practice Location Address Fax Number:
814-438-7976
Provider Enumeration Date:
06/20/2005