Provider First Line Business Practice Location Address:
1150 WASHINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-9683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-7246
Provider Business Practice Location Address Fax Number:
724-225-9124
Provider Enumeration Date:
09/16/2006