Provider First Line Business Practice Location Address:
531 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-3071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-600-0120
Provider Business Practice Location Address Fax Number:
724-600-0659
Provider Enumeration Date:
05/02/2007