Provider First Line Business Practice Location Address:
819 S 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19147-2871
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-592-8888
Provider Business Practice Location Address Fax Number:
215-592-9888
Provider Enumeration Date:
12/03/2020