Provider First Line Business Practice Location Address:
ONE DEACONESS RD/WEST CC-2
Provider Second Line Business Practice Location Address:
BETH ISRAEL DEACONESS MED CTR
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-754-2339
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2006