Provider First Line Business Practice Location Address:
RT 130 AND N GREENGATE ROAD
Provider Second Line Business Practice Location Address:
NORTH GREENGATE PROFESSIONAL BUILDING
Provider Business Practice Location Address City Name:
JEANNETTE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-838-1500
Provider Business Practice Location Address Fax Number:
724-838-1505
Provider Enumeration Date:
10/28/2005