Provider First Line Business Practice Location Address:
8815 GERMANTOWN AVE
Provider Second Line Business Practice Location Address:
#36
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-242-5300
Provider Business Practice Location Address Fax Number:
215-242-5700
Provider Enumeration Date:
04/18/2006