Provider First Line Business Practice Location Address:
6396 STATE ROUTE 819 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-3670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-547-3627
Provider Business Practice Location Address Fax Number:
724-547-0350
Provider Enumeration Date:
09/06/2011