Provider First Line Business Practice Location Address:
118 W HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EBENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15931-1539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-472-9330
Provider Business Practice Location Address Fax Number:
814-472-8957
Provider Enumeration Date:
05/12/2008