Provider First Line Business Practice Location Address:
223 SOUTH PLEASANT AVENUE
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-444-6181
Provider Business Practice Location Address Fax Number:
814-444-6977
Provider Enumeration Date:
09/26/2019