Provider First Line Business Practice Location Address:
140 ALLENDALE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KING OF PRUSSIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19406-2939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-265-0344
Provider Business Practice Location Address Fax Number:
610-265-0308
Provider Enumeration Date:
10/01/2006