Provider First Line Business Practice Location Address: 
1400 LOCUST ST
    Provider Second Line Business Practice Location Address: 
11500L, BUILDING B
    Provider Business Practice Location Address City Name: 
PITTSBURGH
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15219-5114
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
412-232-8939
    Provider Business Practice Location Address Fax Number: 
412-232-8938
    Provider Enumeration Date: 
10/06/2006