Provider First Line Business Practice Location Address:
425 PHILADELPHIA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-3909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-349-1184
Provider Business Practice Location Address Fax Number:
724-463-1194
Provider Enumeration Date:
08/03/2006