Provider First Line Business Practice Location Address:
36 DEARBORN
Provider Second Line Business Practice Location Address:
UPHAMS ELDER SERVICE PLAN
Provider Business Practice Location Address City Name:
ROXBURY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02119-2552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-440-1646
Provider Business Practice Location Address Fax Number:
617-442-2589
Provider Enumeration Date:
06/25/2008