Provider First Line Business Practice Location Address:
550 FAYETTE ST
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:
15301-5517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-222-6922
Provider Business Practice Location Address Fax Number:
724-222-7366
Provider Enumeration Date:
09/21/2007