Provider First Line Business Practice Location Address:
507 W NEWTON 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:
15601-2819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-853-1910
Provider Business Practice Location Address Fax Number:
724-853-1930
Provider Enumeration Date:
06/11/2006