Provider First Line Business Practice Location Address:
3720 NEW GERMANY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EBENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15931-1862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-472-9390
Provider Business Practice Location Address Fax Number:
814-472-1166
Provider Enumeration Date:
12/22/2011