Provider First Line Business Practice Location Address:
389 MORGANTOWN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-4880
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-434-2225
Provider Business Practice Location Address Fax Number:
724-434-1454
Provider Enumeration Date:
09/19/2005