Provider First Line Business Practice Location Address:
339 WEST UNION STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501-1543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-444-8300
Provider Business Practice Location Address Fax Number:
814-443-3959
Provider Enumeration Date:
03/26/2007