Provider First Line Business Practice Location Address:
401 SHADY AVE
Provider Second Line Business Practice Location Address:
STE B104
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-361-4144
Provider Business Practice Location Address Fax Number:
412-687-3949
Provider Enumeration Date:
05/21/2007