Provider First Line Business Practice Location Address:
2005 EAGLE RIDGE DR
Provider Second Line Business Practice Location Address:
SOUTH PARK HIGH SCHOOL
Provider Business Practice Location Address City Name:
SOUTH PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15129-9289
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-655-4900
Provider Business Practice Location Address Fax Number:
412-655-4505
Provider Enumeration Date:
01/17/2008