Provider First Line Business Practice Location Address:
5730 ELLSWORTH AVE
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15232-1741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-404-2626
Provider Business Practice Location Address Fax Number:
412-404-2446
Provider Enumeration Date:
11/14/2006