Provider First Line Business Practice Location Address:
230 WEST WASHINGTON SQUARE
Provider Second Line Business Practice Location Address:
4TH FLOUR
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-829-3561
Provider Business Practice Location Address Fax Number:
215-829-3020
Provider Enumeration Date:
05/04/2009