Provider First Line Business Practice Location Address:
ROUTE 819 BOX 1052
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-3052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-547-5590
Provider Business Practice Location Address Fax Number:
724-542-8483
Provider Enumeration Date:
05/26/2010