Provider First Line Business Practice Location Address:
289 NORTH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-3512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-223-7801
Provider Business Practice Location Address Fax Number:
724-223-7802
Provider Enumeration Date:
06/06/2007