Provider First Line Business Practice Location Address: 
1500 E MEDICAL CENTER DRIVE
    Provider Second Line Business Practice Location Address: 
2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
    Provider Business Practice Location Address City Name: 
ANN ARBOR
    Provider Business Practice Location Address State Name: 
MI
    Provider Business Practice Location Address Postal Code: 
48109-5054
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
800-862-7284
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
12/08/2011