Provider First Line Business Practice Location Address:
2000 SPRING GARDEN ST
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:
19130-3994
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-564-3618
Provider Business Practice Location Address Fax Number:
215-564-2239
Provider Enumeration Date:
10/26/2009