Provider First Line Business Practice Location Address:
4284 CASTLETOWN SQ S
Provider Second Line Business Practice Location Address:
CASTLETOWN SQUARE SO
Provider Business Practice Location Address City Name:
ALLISON PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15101-1433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-486-7311
Provider Business Practice Location Address Fax Number:
412-486-8402
Provider Enumeration Date:
11/17/2005