Provider First Line Business Practice Location Address: 
1245 HIGHLAND AVE STE 600
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
ABINGTON
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
19001-3727
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
215-887-3990
    Provider Business Practice Location Address Fax Number: 
215-887-1140
    Provider Enumeration Date: 
12/26/2005