Provider First Line Business Practice Location Address:
12120 STATE ROUTE 30
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15642-1840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-863-4362
Provider Business Practice Location Address Fax Number:
724-863-6024
Provider Enumeration Date:
01/05/2009