Provider First Line Business Practice Location Address:
4900 FRANKFORD AVE
Provider Second Line Business Practice Location Address:
ATTN: RADIOLOGY
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19124-2618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-612-2610
Provider Business Practice Location Address Fax Number:
215-612-5077
Provider Enumeration Date:
09/30/2005