Provider First Line Business Practice Location Address:
1380 OLD FREEPORT RD
Provider Second Line Business Practice Location Address:
SUITE 2B
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15238-3127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-417-9163
Provider Business Practice Location Address Fax Number:
724-935-6610
Provider Enumeration Date:
08/11/2006