Provider First Line Business Practice Location Address:
807 WALLACE AVENUE
Provider Second Line Business Practice Location Address:
HOSANNA HOUSE, ROOM 402
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-247-7817
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2013