Provider First Line Business Practice Location Address:
12 QUAKER VILLAGE SHOPPING CENTER
Provider Second Line Business Practice Location Address:
STE 2A OHIO RIVER BLVD
Provider Business Practice Location Address City Name:
SEWICKLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-773-4663
Provider Business Practice Location Address Fax Number:
412-749-6787
Provider Enumeration Date:
06/30/2008