Provider First Line Business Practice Location Address:
120 FERRELL AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WIND RIDGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-428-4242
Provider Business Practice Location Address Fax Number:
724-428-4669
Provider Enumeration Date:
06/06/2007