Provider First Line Business Practice Location Address:
37 E FAYETTE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-4252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-439-4327
Provider Business Practice Location Address Fax Number:
724-439-1635
Provider Enumeration Date:
01/15/2010