Provider First Line Business Practice Location Address:
279 LINCOLN ST
Provider Second Line Business Practice Location Address:
UMASS MEMORIAL MED CTR, AMBULATORY PSYCHIATRY SERVICE
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01605-2120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-334-2537
Provider Business Practice Location Address Fax Number:
508-334-3000
Provider Enumeration Date:
11/12/2009