Provider First Line Business Practice Location Address:
3221 KENSINGTON AVE
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:
19134-1934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-425-6900
Provider Business Practice Location Address Fax Number:
215-423-6911
Provider Enumeration Date:
04/30/2024