Provider First Line Business Practice Location Address:
230 W WASHINGTON SQUARE
Provider Second Line Business Practice Location Address:
FARM JOURNAL BUILDING 5TH FLOOR
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19106-3500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-829-3668
Provider Business Practice Location Address Fax Number:
215-829-5002
Provider Enumeration Date:
05/01/2008