Provider First Line Business Practice Location Address:
850 HOSPITAL RD
Provider Second Line Business Practice Location Address:
MEDICAL ARTS BLDG
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-3663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-464-0270
Provider Business Practice Location Address Fax Number:
724-464-0274
Provider Enumeration Date:
07/11/2005