Provider First Line Business Practice Location Address:
793 OLD ROUTE 119 HWY N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-1372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-349-7060
Provider Business Practice Location Address Fax Number:
724-349-7075
Provider Enumeration Date:
02/19/2007