Provider First Line Business Practice Location Address:
4314 OLD WILLIAM PENN HWY
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
MONROEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15146-1455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-858-5101
Provider Business Practice Location Address Fax Number:
412-858-5105
Provider Enumeration Date:
06/23/2006