Provider First Line Business Practice Location Address:
JOHN D. DINGELL VA MEDICAL CENTER, 4646 JOHN R. ST
Provider Second Line Business Practice Location Address:
553/11G-PM
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:
313-576-4760
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2006