Provider First Line Business Practice Location Address:
2 E MOODY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-2356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-562-5552
Provider Business Practice Location Address Fax Number:
724-652-9378
Provider Enumeration Date:
02/13/2006