Provider First Line Business Practice Location Address:
118-120 S. 52 ST.
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:
19139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-472-6900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2007