Provider First Line Business Practice Location Address:
80 HUFF AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-836-3368
Provider Business Practice Location Address Fax Number:
724-836-1209
Provider Enumeration Date:
11/20/2014