Provider First Line Business Practice Location Address:
1630 LINCOLN WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCKEESPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15131-1714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-682-4005
Provider Business Practice Location Address Fax Number:
412-681-8502
Provider Enumeration Date:
11/06/2006