Provider First Line Business Practice Location Address:
446 RANDOLPH ST
Provider Second Line Business Practice Location Address:
HIP HOP CLINIC
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94132-3122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-337-4719
Provider Business Practice Location Address Fax Number:
415-337-4719
Provider Enumeration Date:
01/08/2007