Provider First Line Business Practice Location Address:
281 BAILIES RUN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CREIGHTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15030-1001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-767-9445
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2005