Provider First Line Business Practice Location Address:
356 FREEPORT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW KENSINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15068-6071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-367-2400
Provider Business Practice Location Address Fax Number:
724-367-2401
Provider Enumeration Date:
07/18/2006