Provider First Line Business Practice Location Address:
3472 ROUTE 130
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISON CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15636-1203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-744-0020
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2006