Provider First Line Business Practice Location Address:
1600 WILDLIFE LODGE RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LOWER BURRELL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15068-3652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-334-2000
Provider Business Practice Location Address Fax Number:
724-334-4500
Provider Enumeration Date:
12/29/2010