Provider First Line Business Practice Location Address:
7500 GERMANTOWN AVE
Provider Second Line Business Practice Location Address:
NEW COVENANT CAMPUS, ELDERS HALL, SUITE 5
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-242-2235
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/17/2015