Provider First Line Business Practice Location Address:
119 E DEKALB PIKE
Provider Second Line Business Practice Location Address:
WALGREENS PHARMACY
Provider Business Practice Location Address City Name:
KING OF PRUSSIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19406-2114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-962-9627
Provider Business Practice Location Address Fax Number:
610-962-9086
Provider Enumeration Date:
11/30/2011