Provider First Line Business Practice Location Address:
4401 PENN AVENUE
Provider Second Line Business Practice Location Address:
FACULTY OFFICE PAVILION, 3RD FLOOR, PEDIATRIC HOSPITAL
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15224-2524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-692-5135
Provider Business Practice Location Address Fax Number:
412-692-7038
Provider Enumeration Date:
02/16/2006