Provider First Line Business Practice Location Address:
315 LOCUST STREET, 2ND FLOOR
Provider Second Line Business Practice Location Address:
JOHNSTOWN, PA 15901
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-534-6242
Provider Business Practice Location Address Fax Number:
814-534-6731
Provider Enumeration Date:
04/25/2022