Provider First Line Business Practice Location Address:
1300 PHILADELPHIA AVE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
NORTHERN CAMBRIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15714-1166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-948-8220
Provider Business Practice Location Address Fax Number:
814-948-8223
Provider Enumeration Date:
11/25/2013