Provider First Line Business Practice Location Address:
1000 N BETHLEHEM PIKE SUITE 117
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING HOUSE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-646-6530
Provider Business Practice Location Address Fax Number:
215-542-0508
Provider Enumeration Date:
05/07/2007