Provider First Line Business Practice Location Address:
1017 PERRY HWY
Provider Second Line Business Practice Location Address:
STE 3
Provider Business Practice Location Address City Name:
PGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15237-2173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-366-3978
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/19/2005