Provider First Line Business Practice Location Address:
3239 STATE ROUTE 981
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ALEXANDRIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15670-2522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-639-9066
Provider Business Practice Location Address Fax Number:
724-639-3472
Provider Enumeration Date:
10/28/2009