Provider First Line Business Practice Location Address:
235 N BROAD ST
Provider Second Line Business Practice Location Address:
SUITE 200 CLINICAL NEPHROLOGY ASSOC
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-762-7785
Provider Business Practice Location Address Fax Number:
215-568-6007
Provider Enumeration Date:
09/23/2006