Provider First Line Business Practice Location Address:
2 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MASONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15461-1847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-583-1925
Provider Business Practice Location Address Fax Number:
724-583-2750
Provider Enumeration Date:
11/07/2006