Provider First Line Business Practice Location Address:
34TH ST & CIVIC CENTER BLVD.
Provider Second Line Business Practice Location Address:
THE CHILDREN'S HOSPITAL OF PHILADELPHIA
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-590-5538
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/17/2009