Provider First Line Business Practice Location Address:
401 N HIGHLAND AVE
Provider Second Line Business Practice Location Address:
VINTAGE/COMMUNITY LIFE
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15206-2926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-952-1447
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2006