Provider First Line Business Practice Location Address:
210 INDUSTRIAL PARK RD STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15904-1948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-534-6100
Provider Business Practice Location Address Fax Number:
814-534-6105
Provider Enumeration Date:
01/11/2017