Provider First Line Business Practice Location Address:
47 EMERY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EIGHTY FOUR
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15330-2109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-229-7218
Provider Business Practice Location Address Fax Number:
724-229-7452
Provider Enumeration Date:
06/28/2010