Provider First Line Business Practice Location Address:
154 HOSPITAL DRIVE, SUITE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TYRONE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-470-7732
Provider Business Practice Location Address Fax Number:
866-422-9899
Provider Enumeration Date:
02/15/2006