Provider First Line Business Practice Location Address: 
7125 SALTSBURG RD
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
PITTSBURGH
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15235-2252
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
412-795-1170
    Provider Business Practice Location Address Fax Number: 
412-795-1154
    Provider Enumeration Date: 
02/12/2007