Provider First Line Business Practice Location Address:
238 W ALLEGHENY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IMPERIAL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15126-9775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-695-8477
Provider Business Practice Location Address Fax Number:
724-695-4688
Provider Enumeration Date:
06/29/2006