Provider First Line Business Practice Location Address: 
1307 FEDERAL ST
    Provider Second Line Business Practice Location Address: 
SUITE B300
    Provider Business Practice Location Address City Name: 
PITTSBURGH
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15212-4769
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
412-359-3751
    Provider Business Practice Location Address Fax Number: 
412-359-8439
    Provider Enumeration Date: 
11/02/2005