Provider First Line Business Practice Location Address:
212 WELLNESS WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-9697
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
172-422-5368
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2026