Provider First Line Business Practice Location Address:
469 JOHNSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JENKINTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-758-2748
Provider Business Practice Location Address Fax Number:
215-758-2977
Provider Enumeration Date:
06/28/2011