Provider First Line Business Practice Location Address:
924 ARCH ST BSMT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-574-8888
Provider Business Practice Location Address Fax Number:
215-574-8888
Provider Enumeration Date:
03/09/2009