Provider First Line Business Practice Location Address:
UNIVERSITY PEDIATRICIANS
Provider Second Line Business Practice Location Address:
4201 ST. ANTIONE UHC 5D # 226
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-966-5051
Provider Business Practice Location Address Fax Number:
313-966-0665
Provider Enumeration Date:
06/15/2013