Provider First Line Business Practice Location Address:
609 SOMERSET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINDBER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15963-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-467-5513
Provider Business Practice Location Address Fax Number:
814-467-8455
Provider Enumeration Date:
04/14/2006