Provider First Line Business Practice Location Address:
249 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EVERETT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15537-7020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-623-1166
Provider Business Practice Location Address Fax Number:
814-623-6149
Provider Enumeration Date:
11/07/2006