Provider First Line Business Practice Location Address:
4808 W VERNOR
Provider Second Line Business Practice Location Address:
MICHIGAN HEALTH CENTER
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-843-2500
Provider Business Practice Location Address Fax Number:
248-356-3442
Provider Enumeration Date:
08/01/2006