Provider First Line Business Practice Location Address:
8500 ESSINGTON AVE
Provider Second Line Business Practice Location Address:
TERMINAL AB LINK, SUITE AB-3A
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19153-7001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-365-6301
Provider Business Practice Location Address Fax Number:
215-365-6302
Provider Enumeration Date:
09/29/2010