Provider First Line Business Practice Location Address:
1211 WILMINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16105-2516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-824-4096
Provider Business Practice Location Address Fax Number:
724-269-9476
Provider Enumeration Date:
02/15/2012