Provider First Line Business Practice Location Address:
127 SIMPSON RD STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15417-8622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-785-7080
Provider Business Practice Location Address Fax Number:
724-785-5048
Provider Enumeration Date:
12/30/2005