Provider First Line Business Practice Location Address:
464 ALLEGHENY BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16323-6210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-432-9801
Provider Business Practice Location Address Fax Number:
814-432-9805
Provider Enumeration Date:
11/24/2006