Provider First Line Business Practice Location Address:
1 UNIVERSITY MEWS
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:
19104-4756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-823-5800
Provider Business Practice Location Address Fax Number:
215-823-4309
Provider Enumeration Date:
08/22/2006