Provider First Line Business Practice Location Address:
34TH & CIVIC CENTER
Provider Second Line Business Practice Location Address:
5TH FLOOR WOOD BUILDING CHILDREN'S HOSPITAL OF PHILADEL
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104-4399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-590-1000
Provider Business Practice Location Address Fax Number:
215-590-4529
Provider Enumeration Date:
07/10/2008