Provider First Line Business Practice Location Address: 
4146 LIBRARY RD
    Provider Second Line Business Practice Location Address: 
SUITE E
    Provider Business Practice Location Address City Name: 
PITTSBURGH
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15234-1350
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
412-833-6663
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
05/03/2007