Provider First Line Business Practice Location Address:
2750 WILLIAM PENN AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15909-1031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-322-1551
Provider Business Practice Location Address Fax Number:
814-322-1552
Provider Enumeration Date:
04/14/2017