Provider First Line Business Practice Location Address:
501 FREEPORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHARPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15215-3215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-720-9496
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2010