Provider First Line Business Practice Location Address:
145 SOUTH ST
Provider Second Line Business Practice Location Address:
SOUTH COVE COMMUNITY HEALTH CENTER
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02111-2826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-521-6760
Provider Business Practice Location Address Fax Number:
671-521-6795
Provider Enumeration Date:
10/20/2006