Provider First Line Business Practice Location Address:
307 23RD STREET EXT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHARPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15215-2821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-545-1600
Provider Business Practice Location Address Fax Number:
724-923-6023
Provider Enumeration Date:
08/28/2023