Provider First Line Business Practice Location Address:
420 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONONGAHELA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15063-2552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-258-8680
Provider Business Practice Location Address Fax Number:
724-258-2920
Provider Enumeration Date:
01/04/2006