Provider First Line Business Practice Location Address:
8118 OLD YORK ROAD, UL SUITE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKINS PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19027-1423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-635-5575
Provider Business Practice Location Address Fax Number:
215-635-5456
Provider Enumeration Date:
11/09/2006