Provider First Line Business Practice Location Address:
50 WEST MAIN ST
Provider Second Line Business Practice Location Address:
STE 704
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-439-9698
Provider Business Practice Location Address Fax Number:
724-439-9701
Provider Enumeration Date:
04/19/2006