Provider First Line Business Practice Location Address:
7335 FRANKFORD 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:
19136-3929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-335-1220
Provider Business Practice Location Address Fax Number:
215-335-2517
Provider Enumeration Date:
01/13/2009