Provider First Line Business Practice Location Address:
508 S CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-1702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-832-4095
Provider Business Practice Location Address Fax Number:
724-830-8613
Provider Enumeration Date:
06/20/2013