Provider First Line Business Practice Location Address:
51 NORTH 39TH STREET
Provider Second Line Business Practice Location Address:
MEDICAL OFFICE BUILDING SUITE 120 (TRAUMA)
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-316-5151
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2010