Provider First Line Business Practice Location Address:
2600 PHILMONT AVENUE
Provider Second Line Business Practice Location Address:
FAIRWAY PLAZA - SUITE 114
Provider Business Practice Location Address City Name:
HUNTINGDON VALLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-947-4910
Provider Business Practice Location Address Fax Number:
215-947-1494
Provider Enumeration Date:
04/02/2009