Provider First Line Business Practice Location Address:
THE LANKENAU MEDICAL OFFICE BUILDING -EAST
Provider Second Line Business Practice Location Address:
100 LANCASTER AVENUE SUITE 353
Provider Business Practice Location Address City Name:
WYNNEWOOD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19096-3433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-228-2820
Provider Business Practice Location Address Fax Number:
610-228-2218
Provider Enumeration Date:
05/09/2019