Provider First Line Business Practice Location Address:
227 FRANKLIN ST
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15901-1916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-539-9636
Provider Business Practice Location Address Fax Number:
814-535-4497
Provider Enumeration Date:
12/20/2005