Provider First Line Business Practice Location Address:
2232 S 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19148-3261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-467-1220
Provider Business Practice Location Address Fax Number:
215-467-1447
Provider Enumeration Date:
07/23/2007