Provider First Line Business Practice Location Address:
1020 PENN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILKINSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15221-2347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-378-2191
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/09/2026