Provider First Line Business Practice Location Address:
3600 MARKET ST
Provider Second Line Business Practice Location Address:
SCIENCE LEADERSHIP ACADEMY MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-3021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-400-8320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2019