Provider First Line Business Practice Location Address:
1215 S BRADDOCK AVE
Provider Second Line Business Practice Location Address:
APARTMENT #5
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15218-1256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-886-2818
Provider Business Practice Location Address Fax Number:
412-882-2853
Provider Enumeration Date:
01/22/2009