Provider First Line Business Practice Location Address:
130 W VONDERSMITH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15522-1727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-623-6534
Provider Business Practice Location Address Fax Number:
814-623-0648
Provider Enumeration Date:
01/03/2006