Provider First Line Business Practice Location Address:
344 BUDFIELD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15904-3214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-266-4949
Provider Business Practice Location Address Fax Number:
814-266-4948
Provider Enumeration Date:
04/05/2006