Provider First Line Business Practice Location Address:
160 GREENE PLZ
Provider Second Line Business Practice Location Address:
RTS 21 & 79
Provider Business Practice Location Address City Name:
WAYNESBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15370-8142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-852-2504
Provider Business Practice Location Address Fax Number:
724-852-2547
Provider Enumeration Date:
09/26/2012