Provider First Line Business Practice Location Address:
243 JOHNSTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UPPER SAINT CLAIR
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15241-2534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-347-3205
Provider Business Practice Location Address Fax Number:
412-831-8422
Provider Enumeration Date:
03/01/2011