Provider First Line Business Practice Location Address:
1915 RIDGE ROAD EXT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMBRIDGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15003-1035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-420-7598
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/26/2026