Provider First Line Business Practice Location Address:
399 S 34TH ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL PENN TOWER, STUDENT HEALTH SERVICE
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-4316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-746-0829
Provider Business Practice Location Address Fax Number:
215-746-1032
Provider Enumeration Date:
06/12/2007