Provider First Line Business Practice Location Address:
1145 E MAIDEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-3737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-222-0380
Provider Business Practice Location Address Fax Number:
724-222-8808
Provider Enumeration Date:
06/28/2007