Provider First Line Business Practice Location Address:
1385 WASHINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-9674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-222-2605
Provider Business Practice Location Address Fax Number:
724-222-2509
Provider Enumeration Date:
07/26/2006