Provider First Line Business Practice Location Address:
718 WALLACE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILKINSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15221-2215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-371-9667
Provider Business Practice Location Address Fax Number:
412-371-4058
Provider Enumeration Date:
06/12/2006