Provider First Line Business Practice Location Address:
4641 ROOSEVELT BLVD, FRIENDS HOSPITAL
Provider Second Line Business Practice Location Address:
ROOM 231
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-831-4577
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2015