Provider First Line Business Practice Location Address:
13450 EAST 12 MILE RD
Provider Second Line Business Practice Location Address:
ADVANCED DERMATOLOGY OF MICHIGAN, PC
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48088
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-219-5960
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2009