Provider First Line Business Practice Location Address:
399 MUNICIPAL RD
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:
15931-7612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-471-2969
Provider Business Practice Location Address Fax Number:
814-886-8573
Provider Enumeration Date:
07/05/2006