Provider First Line Business Practice Location Address:
4109 CAMBRIDGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRWIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15642-3239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-610-4060
Provider Business Practice Location Address Fax Number:
412-610-4060
Provider Enumeration Date:
01/05/2026