Provider First Line Business Practice Location Address:
3401 NORTH BROAD STREET
Provider Second Line Business Practice Location Address:
DEPT OF PATH & LAB MED - RM.B243,OPB
Provider Business Practice Location Address City Name:
PHILADELPHIA, PA 19140
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:
215-707-4353
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/14/2024