Provider First Line Business Practice Location Address:
2450 W HUNTING PARK AVE
Provider Second Line Business Practice Location Address:
TPI 2ND FL
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19129-1302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-926-9019
Provider Business Practice Location Address Fax Number:
215-226-8286
Provider Enumeration Date:
12/15/2005