Provider First Line Business Practice Location Address:
1384 OLD FREEPORT RD
Provider Second Line Business Practice Location Address:
SUITE 1A
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-963-6945
Provider Business Practice Location Address Fax Number:
412-963-1131
Provider Enumeration Date:
10/24/2006