Provider First Line Business Practice Location Address:
3600 SPRUCE STREET, 2 MALONEY
Provider Second Line Business Practice Location Address:
HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA
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:
215-662-2737
Provider Business Practice Location Address Fax Number:
215-662-7884
Provider Enumeration Date:
04/23/2018