Provider First Line Business Practice Location Address:
500 MEDICAL ARTS BLDG
Provider Second Line Business Practice Location Address:
SUITE 540
Provider Business Practice Location Address City Name:
KITTANNING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16201-7137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-543-4942
Provider Business Practice Location Address Fax Number:
724-543-8865
Provider Enumeration Date:
09/25/2006