Provider First Line Business Practice Location Address:
341 ELIZABETH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-2743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-366-0158
Provider Business Practice Location Address Fax Number:
724-438-7755
Provider Enumeration Date:
12/29/2006