Provider First Line Business Practice Location Address:
500 W GERMANTOWN PIKE
Provider Second Line Business Practice Location Address:
CHURCH ON THE MALL, PLYMOUTH MEETING MALL, BOX 80
Provider Business Practice Location Address City Name:
PLYMOUTH MEETING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-291-3391
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2006