Provider First Line Business Practice Location Address:
2300 E. ALLEGHENY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-425-2288
Provider Business Practice Location Address Fax Number:
215-425-0575
Provider Enumeration Date:
01/30/2007