Provider First Line Business Practice Location Address:
TEMPLE UNIVERSITY HOSPITAL
Provider Second Line Business Practice Location Address:
BOYER PAVILION 2ND FLOOR,3509 NORTH BROAD STREET
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-707-4739
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2009