Provider First Line Business Practice Location Address:
31 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAHANOY CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17948-2647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-773-4032
Provider Business Practice Location Address Fax Number:
570-773-3041
Provider Enumeration Date:
04/08/2022