Provider First Line Business Practice Location Address:
301 INDEPENDENCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PERRYOPOLIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-736-4422
Provider Business Practice Location Address Fax Number:
724-736-0715
Provider Enumeration Date:
03/02/2011