Provider First Line Business Practice Location Address: 
100 S JACKSON AVE
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
PITTSBURGH
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15202-3428
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
412-920-5860
    Provider Business Practice Location Address Fax Number: 
412-920-5861
    Provider Enumeration Date: 
05/31/2011