Provider First Line Business Practice Location Address: 
UNIVERSITY HEALTH SERVICES
    Provider Second Line Business Practice Location Address: 
EASTERN MICHIGAN UNIVERSITY
    Provider Business Practice Location Address City Name: 
YPSILANTI
    Provider Business Practice Location Address State Name: 
MI
    Provider Business Practice Location Address Postal Code: 
48197-2207
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
734-487-1122
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
02/23/2007