Provider First Line Business Practice Location Address:
2697 ROUTE 18
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOOKSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-899-3144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2005