Provider First Line Business Practice Location Address:
6401 EAST 1 1/2 MILE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAULT STE MARIE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
906-253-9353
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/05/2007