Provider First Line Business Practice Location Address:
110 OLD CONCORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PROSPERITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15329-1422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-257-2290
Provider Business Practice Location Address Fax Number:
724-884-0377
Provider Enumeration Date:
02/23/2010