Provider First Line Business Practice Location Address:
1400 REED 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:
19146-4823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-755-0500
Provider Business Practice Location Address Fax Number:
215-755-3561
Provider Enumeration Date:
01/25/2006