Provider First Line Business Practice Location Address:
3400 SPRUCE STREET, 4 MALONEY
Provider Second Line Business Practice Location Address:
DEPARTMENT OF SURGERY, SURGERY EDUCATION
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-537-7653
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2019