Provider First Line Business Practice Location Address:
603 N CHURCH ST STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-1065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-547-3445
Provider Business Practice Location Address Fax Number:
724-547-3319
Provider Enumeration Date:
02/05/2007