Provider First Line Business Practice Location Address:
34TH STREET AND CIVIC CENTER BOULVEVARD
Provider Second Line Business Practice Location Address:
2ND FLOOR, WOOD BUILDING - DIVISION OF ORTHOPEDICS
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-590-1534
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/06/2012