Provider First Line Business Practice Location Address:
4400 OLD WILLIAM PENN HWY
Provider Second Line Business Practice Location Address:
STE 202
Provider Business Practice Location Address City Name:
MONROEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15146-1480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-856-6588
Provider Business Practice Location Address Fax Number:
412-856-0277
Provider Enumeration Date:
06/21/2005