Provider First Line Business Practice Location Address:
1306 SPRING GARDEN ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19123-3213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-238-2150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2007