Provider First Line Business Practice Location Address:
145 SOUTH STREET
Provider Second Line Business Practice Location Address:
WIC/NUTRITION DEPARTMENT
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-521-6774
Provider Business Practice Location Address Fax Number:
617-521-6797
Provider Enumeration Date:
08/06/2020