Provider First Line Business Practice Location Address:
510 CLIFTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLLINGDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19023-3615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-583-3040
Provider Business Practice Location Address Fax Number:
610-583-3020
Provider Enumeration Date:
10/04/2006