Provider First Line Business Practice Location Address:
1340 OLD FREEPORT ROAD
Provider Second Line Business Practice Location Address:
SUITE 1A
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15238-4101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-967-9505
Provider Business Practice Location Address Fax Number:
412-967-9507
Provider Enumeration Date:
04/22/2006