Provider First Line Business Practice Location Address:
490 E NORTH AVE STE 207
Provider Second Line Business Practice Location Address:
ALLEGHENY PROFESSIONAL BLDG
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15212-4740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-321-1810
Provider Business Practice Location Address Fax Number:
412-321-2005
Provider Enumeration Date:
10/11/2007