Provider First Line Business Practice Location Address:
537 E ALLEGHENY AVE
Provider Second Line Business Practice Location Address:
APT/SUITE
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19134-2328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-291-9500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2013