Provider First Line Business Practice Location Address:
225 S CENTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-394-4445
Provider Business Practice Location Address Fax Number:
706-955-0735
Provider Enumeration Date:
08/03/2005