Provider First Line Business Practice Location Address:
1015 FRANKLIN ST
Provider Second Line Business Practice Location Address:
LEVEL A
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15905-4110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-536-9715
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/10/2014