Provider First Line Business Practice Location Address:
1916 OAKLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-3380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-463-0199
Provider Business Practice Location Address Fax Number:
724-463-8944
Provider Enumeration Date:
08/22/2007