Provider First Line Business Practice Location Address:
1900 WATERDAM PLAZA DR BLDG 32ND
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANONSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-5442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-941-7490
Provider Business Practice Location Address Fax Number:
724-941-5231
Provider Enumeration Date:
08/01/2005