Provider First Line Business Practice Location Address:
1370 WASHINGTON PIKE
Provider Second Line Business Practice Location Address:
SUITE 107
Provider Business Practice Location Address City Name:
BRIDGEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15017-2839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-221-0160
Provider Business Practice Location Address Fax Number:
412-221-0860
Provider Enumeration Date:
08/04/2005