Provider First Line Business Practice Location Address:
HENRY FORD HEALTH SYSTEM
Provider Second Line Business Practice Location Address:
44405 WOODWARD H-24
Provider Business Practice Location Address City Name:
PONTIAC
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-858-3526
Provider Business Practice Location Address Fax Number:
248-858-3532
Provider Enumeration Date:
11/01/2006