Provider First Line Business Practice Location Address:
3900 WOODLAND AVENUE
Provider Second Line Business Practice Location Address:
PATHOLOGY & LAB. MED. (113) - VAMC CLIN. ADD. BLDG.
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-4551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-823-5182
Provider Business Practice Location Address Fax Number:
215-823-4271
Provider Enumeration Date:
10/04/2006