Provider First Line Business Practice Location Address:
2835 TYSON AVENUE
Provider Second Line Business Practice Location Address:
GW TEMPLE FAMILY MEDICAL ASSOCIATES
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-624-6162
Provider Business Practice Location Address Fax Number:
215-624-3732
Provider Enumeration Date:
08/04/2009