Provider First Line Business Practice Location Address:
1360 OLD FREEPORT RD
Provider Second Line Business Practice Location Address:
SUITES 3A & 3B
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15238-4102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-963-7077
Provider Business Practice Location Address Fax Number:
412-963-7083
Provider Enumeration Date:
08/04/2005