Provider First Line Business Practice Location Address:
UMASSMEMORIAL MEDICAL CENTER, 55 LAKE AVE NORTH
Provider Second Line Business Practice Location Address:
DEPT OF CARE COORDINATION
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
774-442-3879
Provider Business Practice Location Address Fax Number:
774-441-9705
Provider Enumeration Date:
01/30/2018