Provider First Line Business Practice Location Address:
891 HYDE PARK AVENUE
Provider Second Line Business Practice Location Address:
BOSTON PAIN CLINIC AND PRIMARY CARE
Provider Business Practice Location Address City Name:
HYDE PARK
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-361-2166
Provider Business Practice Location Address Fax Number:
617-361-2773
Provider Enumeration Date:
02/05/2007