Provider First Line Business Practice Location Address:
1200 BROOKS LN
Provider Second Line Business Practice Location Address:
SUITE 160
Provider Business Practice Location Address City Name:
CLAIRTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-405-8065
Provider Business Practice Location Address Fax Number:
412-405-8067
Provider Enumeration Date:
08/10/2005