Provider First Line Business Practice Location Address:
6521 FRANKFORD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-624-2303
Provider Business Practice Location Address Fax Number:
215-624-2577
Provider Enumeration Date:
12/01/2005