Provider First Line Business Practice Location Address:
111 INDUSTRIAL PARK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15904-1940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-266-3151
Provider Business Practice Location Address Fax Number:
814-262-9702
Provider Enumeration Date:
04/10/2006