Provider First Line Business Practice Location Address:
CHILDREN'S HOSPITAL OF PHILADELPHIA
Provider Second Line Business Practice Location Address:
550 SOUTH GODDARD BLVD
Provider Business Practice Location Address City Name:
KING OF PRUSSIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-812-3870
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2022