Provider First Line Business Practice Location Address:
609 WEST GERMANTOWN PIKE
Provider Second Line Business Practice Location Address:
MEDICAL ARTS BUILDING - SUITE #120
Provider Business Practice Location Address City Name:
EAST NORRITON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-279-1370
Provider Business Practice Location Address Fax Number:
610-279-1372
Provider Enumeration Date:
08/12/2005