Provider First Line Business Practice Location Address:
RT 819 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT. PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-547-5590
Provider Business Practice Location Address Fax Number:
724-542-8483
Provider Enumeration Date:
08/19/2010