Provider First Line Business Practice Location Address:
1720 S BROAD ST
Provider Second Line Business Practice Location Address:
HEALTH CARE CENTER 2
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19145-2315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-685-1811
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2007