Provider First Line Business Practice Location Address:
633 LONG RUN RD
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
MCKEESPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-751-7466
Provider Business Practice Location Address Fax Number:
412-751-7509
Provider Enumeration Date:
08/23/2006