Provider First Line Business Practice Location Address:
410 PELLIS RD STE 2B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-4700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-834-4448
Provider Business Practice Location Address Fax Number:
724-834-8563
Provider Enumeration Date:
09/19/2005