Provider First Line Business Practice Location Address:
500 OLD YORK ROAD
Provider Second Line Business Practice Location Address:
SUITE #104
Provider Business Practice Location Address City Name:
JENKINTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-886-2268
Provider Business Practice Location Address Fax Number:
215-886-6016
Provider Enumeration Date:
03/08/2007