Provider First Line Business Practice Location Address:
253 KRETCHMAN FARM RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEYERSDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15552-6134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-233-8737
Provider Business Practice Location Address Fax Number:
814-634-0546
Provider Enumeration Date:
12/31/2013