Provider First Line Business Practice Location Address:
93 N MORGANTOWN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRCHANCE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15436-1039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-564-0900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2005