Provider First Line Business Practice Location Address:
750 WASHINGTON ST
Provider Second Line Business Practice Location Address:
FLOATING HOSPITAL, RM 401
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02111-1526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-636-7920
Provider Business Practice Location Address Fax Number:
617-636-9107
Provider Enumeration Date:
04/15/2008