Provider First Line Business Practice Location Address:
108 FRANCISCAN WAY
Provider Second Line Business Practice Location Address:
DISEPIO CENTER FOR REHABILITATION
Provider Business Practice Location Address City Name:
LORETTO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-472-3936
Provider Business Practice Location Address Fax Number:
814-472-3905
Provider Enumeration Date:
11/18/2005