Provider First Line Business Practice Location Address:
222 CLIFTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLLINGDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19023-3712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-583-3232
Provider Business Practice Location Address Fax Number:
610-583-7902
Provider Enumeration Date:
06/09/2006