Provider First Line Business Practice Location Address:
399 S 34TH ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL, PENN TOWER
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-4316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-349-8972
Provider Business Practice Location Address Fax Number:
215-662-4985
Provider Enumeration Date:
03/06/2007