Provider First Line Business Practice Location Address:
203 E. PATRIOT ST.
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-443-9000
Provider Business Practice Location Address Fax Number:
814-444-6127
Provider Enumeration Date:
06/19/2018