Provider First Line Business Practice Location Address:
132 E UNION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501-1415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-714-0001
Provider Business Practice Location Address Fax Number:
814-217-1766
Provider Enumeration Date:
08/18/2016