Provider First Line Business Practice Location Address:
1126 GRANT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUQUESNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15110-1690
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-953-8532
Provider Business Practice Location Address Fax Number:
412-896-5229
Provider Enumeration Date:
11/06/2007