Provider First Line Business Practice Location Address:
1150 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAYNESBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15370-1660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-627-2760
Provider Business Practice Location Address Fax Number:
724-627-2692
Provider Enumeration Date:
01/24/2007