Provider First Line Business Practice Location Address:
160 WAYLAND SMITH DR STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-7500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-438-3300
Provider Business Practice Location Address Fax Number:
724-438-3366
Provider Enumeration Date:
05/13/2012