Provider First Line Business Practice Location Address:
939 FOURTH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORD CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16226-0208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-763-3651
Provider Business Practice Location Address Fax Number:
724-763-2634
Provider Enumeration Date:
01/23/2007