Provider First Line Business Practice Location Address:
615 SALISBURY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEYERSDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15552-0285
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-634-5956
Provider Business Practice Location Address Fax Number:
814-634-9334
Provider Enumeration Date:
10/25/2007