Provider First Line Business Practice Location Address:
261 OLD YORK RD
Provider Second Line Business Practice Location Address:
STE 106
Provider Business Practice Location Address City Name:
JENKINTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19046-3706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-887-2102
Provider Business Practice Location Address Fax Number:
215-887-0525
Provider Enumeration Date:
06/14/2005