Provider First Line Business Practice Location Address:
2513 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCKEESPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15132-1130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-673-1993
Provider Business Practice Location Address Fax Number:
412-673-1996
Provider Enumeration Date:
12/29/2006