Provider First Line Business Practice Location Address:
ERIE AVENUE AT FRONT STREET
Provider Second Line Business Practice Location Address:
ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-427-5284
Provider Business Practice Location Address Fax Number:
215-427-4385
Provider Enumeration Date:
05/05/2006