Provider First Line Business Practice Location Address:
1601 CHERRY ST
Provider Second Line Business Practice Location Address:
PARKWAY HEALTH & WELLNESS CENTER, FLOOR 2
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19102-1320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-359-5505
Provider Business Practice Location Address Fax Number:
267-359-5579
Provider Enumeration Date:
02/26/2014