Provider First Line Business Practice Location Address:
500 ADAMS AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILA.
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19120-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-279-9666
Provider Business Practice Location Address Fax Number:
215-279-9674
Provider Enumeration Date:
12/22/2010