Provider First Line Business Practice Location Address:
1152 WOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALIFORNIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15419-1260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-938-2099
Provider Business Practice Location Address Fax Number:
724-938-3221
Provider Enumeration Date:
11/25/2005