Provider First Line Business Practice Location Address:
94 HOSPITAL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIDGWAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15853-1931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-834-2602
Provider Business Practice Location Address Fax Number:
814-776-2150
Provider Enumeration Date:
07/27/2009