Provider First Line Business Practice Location Address:
2354 ROUTE 119 HWY S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMER CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15748-7325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-479-2259
Provider Business Practice Location Address Fax Number:
724-479-2280
Provider Enumeration Date:
07/28/2006