Provider First Line Business Practice Location Address:
1 S MOUNT VERNON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-3223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-437-9858
Provider Business Practice Location Address Fax Number:
724-438-2890
Provider Enumeration Date:
07/21/2006