Provider First Line Business Practice Location Address:
4190 CITY AVE STE 315
Provider Second Line Business Practice Location Address:
DEPARTMENT OF SURGERY
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19131-1633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-871-6942
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2012