Provider First Line Business Practice Location Address: 
11100 EUCLID AV
    Provider Second Line Business Practice Location Address: 
UNIVERSITY HOSPITALS OF CLEVELAND
    Provider Business Practice Location Address City Name: 
CLEVELAND
    Provider Business Practice Location Address State Name: 
OH
    Provider Business Practice Location Address Postal Code: 
44106-6031
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
216-844-1000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
04/22/2011