Provider First Line Business Practice Location Address:
131 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15901-1628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-623-1212
Provider Business Practice Location Address Fax Number:
814-285-3023
Provider Enumeration Date:
12/28/2010