Provider First Line Business Practice Location Address:
634 OLD YORK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JENKINTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19046-2811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-881-9181
Provider Business Practice Location Address Fax Number:
215-881-9212
Provider Enumeration Date:
01/19/2015