Provider First Line Business Practice Location Address:
20 CEDAR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15228-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-341-5991
Provider Business Practice Location Address Fax Number:
412-341-5994
Provider Enumeration Date:
09/22/2005