Provider First Line Business Practice Location Address:
424 SHADY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIDGEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15017-1962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-221-1900
Provider Business Practice Location Address Fax Number:
412-257-1840
Provider Enumeration Date:
09/21/2005