Provider First Line Business Practice Location Address: 
2801 CUSTER AVE
    Provider Second Line Business Practice Location Address: 
2ND FLOOR
    Provider Business Practice Location Address City Name: 
PITTSBURGH
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15227-3929
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
412-885-6000
    Provider Business Practice Location Address Fax Number: 
412-885-1688
    Provider Enumeration Date: 
10/12/2011