Provider First Line Business Practice Location Address: 
RELIEVUS 9815 ROSSEVELT BLVD
    Provider Second Line Business Practice Location Address: 
UNIT J
    Provider Business Practice Location Address City Name: 
PHILADELPHIA
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
19114
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
888-985-2727
    Provider Business Practice Location Address Fax Number: 
609-567-8832
    Provider Enumeration Date: 
04/24/2013