Provider First Line Business Practice Location Address: 
850 HOSPITAL RD
    Provider Second Line Business Practice Location Address: 
SUITE 2300
    Provider Business Practice Location Address City Name: 
INDIANA
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15701-3662
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
724-357-1855
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
10/25/2006