Provider First Line Business Practice Location Address:
240 BARKER RD
Provider Second Line Business Practice Location Address:
GENESIS PHYSICIAN SERVICES
Provider Business Practice Location Address City Name:
WYNCOTE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19095-1716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-738-1184
Provider Business Practice Location Address Fax Number:
610-335-4486
Provider Enumeration Date:
06/27/2005