Provider First Line Business Practice Location Address:
3550 MARKET ST FL 4
Provider Second Line Business Practice Location Address:
CHOP CARE NETWORK AT 3550 MARKET STREET
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-3368
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-590-2178
Provider Business Practice Location Address Fax Number:
215-590-4619
Provider Enumeration Date:
06/30/2006