Provider First Line Business Practice Location Address:
145 WISSINGER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALIX
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15952-0145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-279-6848
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2012