Provider First Line Business Practice Location Address:
UNIVERSITY PEDIATRICIANS AUTISM CENTER
Provider Second Line Business Practice Location Address:
4501 WOODWARD AVE - SUITE 101
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:
313-577-6143
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2016