Provider First Line Business Practice Location Address:
10800 KNIGHTS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19114-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-612-4000
Provider Business Practice Location Address Fax Number:
215-612-2658
Provider Enumeration Date:
04/12/2011