Provider First Line Business Practice Location Address:
7115 TORRESDALE 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:
19135-1312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-332-3132
Provider Business Practice Location Address Fax Number:
215-332-3122
Provider Enumeration Date:
12/12/2006