Provider First Line Business Mailing Address:
34TH STREET AND CIVIC CENTER BOULEVARD3RD
Provider Second Line Business Mailing Address:
FLOOR WOOD BUILDING, DIVISION OF UROLOGY
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-590-2754
Provider Business Mailing Address Fax Number:
267-426-7335