Provider First Line Business Practice Location Address:
227 HOSPITAL DRIVE, SUITE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EVERETT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-623-9095
Provider Business Practice Location Address Fax Number:
814-623-7837
Provider Enumeration Date:
09/13/2006