Provider First Line Business Practice Location Address:
500 E CHELTEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19144-1203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-848-1985
Provider Business Practice Location Address Fax Number:
215-844-2085
Provider Enumeration Date:
05/14/2007