Provider First Line Business Practice Location Address:
195 TIMBER LAKE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAYSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15323-1323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-663-5464
Provider Business Practice Location Address Fax Number:
724-663-5406
Provider Enumeration Date:
09/19/2007