Provider First Line Business Practice Location Address:
3506 RTE 130
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRWIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-744-0300
Provider Business Practice Location Address Fax Number:
724-744-0303
Provider Enumeration Date:
02/13/2006