Provider First Line Business Practice Location Address:
1800 LOMBARD STREET, 3RD FLOOR
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY - RITTENHOUSE
Provider Business Practice Location Address City Name:
PHILADEPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19146-1498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-893-6423
Provider Business Practice Location Address Fax Number:
215-893-6401
Provider Enumeration Date:
10/07/2008