Provider First Line Business Practice Location Address:
1152 WOOD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALIFORNIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15419-1260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-938-2122
Provider Business Practice Location Address Fax Number:
724-938-7853
Provider Enumeration Date:
01/25/2023