Provider First Line Business Practice Location Address:
900 WALNUT ST.
Provider Second Line Business Practice Location Address:
JEFFERSON UNIVERSITY HOSPITAL
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-503-1340
Provider Business Practice Location Address Fax Number:
215-503-1342
Provider Enumeration Date:
08/02/2006