Provider First Line Business Practice Location Address:
522 W NEWTON ST STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-2890
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-853-8922
Provider Business Practice Location Address Fax Number:
724-853-8925
Provider Enumeration Date:
03/25/2008