Provider First Line Business Practice Location Address:
1612 W STATE ST # PA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-1246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-658-8589
Provider Business Practice Location Address Fax Number:
724-658-8978
Provider Enumeration Date:
12/14/2007