Provider First Line Business Practice Location Address:
5612 PHILLIPS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15217-2205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-337-3886
Provider Business Practice Location Address Fax Number:
412-421-1585
Provider Enumeration Date:
07/23/2009