Provider First Line Business Practice Location Address:
311 23RD STREET EXT STE 500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHARPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15215-2821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-967-9399
Provider Business Practice Location Address Fax Number:
888-909-1368
Provider Enumeration Date:
10/08/2019