Provider First Line Business Practice Location Address:
309 SOUTH MAPLE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBERG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-836-2911
Provider Business Practice Location Address Fax Number:
724-836-3166
Provider Enumeration Date:
01/23/2007