Provider First Line Business Practice Location Address:
230 SOUTH 22ND STREET
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:
19103-5520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-567-4335
Provider Business Practice Location Address Fax Number:
215-567-4337
Provider Enumeration Date:
05/03/2007