Provider First Line Business Practice Location Address:
5000 FORBES AVE
Provider Second Line Business Practice Location Address:
CARNEGIE MELLON UNIVERSITY ATHLETICS DEPARTMENT
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15213-3815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-268-8972
Provider Business Practice Location Address Fax Number:
412-268-4078
Provider Enumeration Date:
08/30/2007