Provider First Line Business Practice Location Address:
20808 ROUTE 19 STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRANBERRY TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16066-6022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-772-7060
Provider Business Practice Location Address Fax Number:
724-772-7061
Provider Enumeration Date:
09/21/2011