Provider First Line Business Practice Location Address:
4716 ELLSWORTH AVE
Provider Second Line Business Practice Location Address:
SUITE 117
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15213-2842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-622-0201
Provider Business Practice Location Address Fax Number:
412-622-6886
Provider Enumeration Date:
12/26/2006