Provider First Line Business Practice Location Address:
101 N MAIN ST
Provider Second Line Business Practice Location Address:
GROUND FL
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-610-9211
Provider Business Practice Location Address Fax Number:
724-219-3942
Provider Enumeration Date:
04/26/2023