Provider First Line Business Practice Location Address:
145 HOSPITAL AVE STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DU BOIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15801-1464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-375-3911
Provider Business Practice Location Address Fax Number:
814-375-4424
Provider Enumeration Date:
10/07/2008