Provider First Line Business Practice Location Address:
7318 FRANKFORD 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:
19136-3827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-332-2200
Provider Business Practice Location Address Fax Number:
215-332-6123
Provider Enumeration Date:
12/08/2006