Provider First Line Business Practice Location Address:
RED LION & KNIGHTS ROAD
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:
19114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-612-5165
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/23/2008