Provider First Line Business Practice Location Address: 
8800 BARNES LAKE RD
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
NORTH HUNTINGDON
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15642-3177
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
412-854-7140
    Provider Business Practice Location Address Fax Number: 
412-854-7142
    Provider Enumeration Date: 
05/25/2011