Provider First Line Business Practice Location Address:
712 N JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-658-0906
Provider Business Practice Location Address Fax Number:
724-652-9241
Provider Enumeration Date:
09/22/2006