Provider First Line Business Practice Location Address:
245 HUMPHREY RD STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-4580
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-853-2353
Provider Business Practice Location Address Fax Number:
724-853-2354
Provider Enumeration Date:
12/11/2008