Provider First Line Business Practice Location Address:
1 NORTHGATE SQ STE 216
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-1397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-256-8256
Provider Business Practice Location Address Fax Number:
888-971-4394
Provider Enumeration Date:
07/22/2011