Provider First Line Business Practice Location Address:
323 OLD YORK RD
Provider Second Line Business Practice Location Address:
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:
215-886-6925
Provider Business Practice Location Address Fax Number:
215-886-6992
Provider Enumeration Date:
05/25/2006