Provider First Line Business Practice Location Address:
4 WOOD SPUR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEETSDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15056-1219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-779-0977
Provider Business Practice Location Address Fax Number:
724-774-6024
Provider Enumeration Date:
09/13/2005