Provider First Line Business Practice Location Address:
916 IDLEWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARNEGIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15106-1212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-218-5796
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/26/2026