Provider First Line Business Practice Location Address:
1102 MALONEY BUILDING
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:
19104-4283
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-789-7366
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2019