Provider First Line Business Practice Location Address:
1 NORTHGATE SQ STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-1395
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-610-2221
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/22/2020