Provider First Line Business Practice Location Address:
3900 WOODLAND AVE
Provider Second Line Business Practice Location Address:
SOCIAL WORK 222
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-4551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-823-5964
Provider Business Practice Location Address Fax Number:
215-823-4558
Provider Enumeration Date:
08/19/2006