Provider First Line Business Practice Location Address:
500 BROADWAY
Provider Second Line Business Practice Location Address:
CITY HALL, HEALTH DEPARTMENT
Provider Business Practice Location Address City Name:
CHELSEA
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02150-2948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-466-4082
Provider Business Practice Location Address Fax Number:
617-466-4089
Provider Enumeration Date:
10/24/2008