Provider First Line Business Practice Location Address:
8001 TORRESDALE AVE
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:
19136-2917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-624-8100
Provider Business Practice Location Address Fax Number:
267-348-0165
Provider Enumeration Date:
07/30/2006