Provider First Line Business Practice Location Address:
3271 ROUTE 119 HWY S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMER CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15748-6901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-479-2440
Provider Business Practice Location Address Fax Number:
814-536-9047
Provider Enumeration Date:
11/03/2006