Provider First Line Business Practice Location Address:
261 OLD YORK ROAD
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
JENKINTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19046-3709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-886-5520
Provider Business Practice Location Address Fax Number:
215-558-6103
Provider Enumeration Date:
05/31/2005