Provider First Line Business Practice Location Address:
239 EDGEWOOD DRIVE EXT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRANSFER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16154-1817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-962-2272
Provider Business Practice Location Address Fax Number:
706-660-1454
Provider Enumeration Date:
10/19/2010