Provider First Line Business Practice Location Address:
550 HAMPTON ST
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:
15601-4446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-747-2188
Provider Business Practice Location Address Fax Number:
724-216-5059
Provider Enumeration Date:
03/06/2007