Provider First Line Business Practice Location Address:
1597 WASHINGTON PIKE
Provider Second Line Business Practice Location Address:
SUITE A15
Provider Business Practice Location Address City Name:
BRIDGEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15017-2894
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-278-1221
Provider Business Practice Location Address Fax Number:
412-278-0201
Provider Enumeration Date:
09/22/2011