Provider First Line Business Practice Location Address:
2106 ROUTE 130
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISON CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15636-1516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-744-3300
Provider Business Practice Location Address Fax Number:
724-744-2351
Provider Enumeration Date:
06/15/2005