Provider First Line Business Practice Location Address:
1451 E LANSING DRIVE
Provider Second Line Business Practice Location Address:
SUITE #225
Provider Business Practice Location Address City Name:
EAST LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-332-8877
Provider Business Practice Location Address Fax Number:
517-332-8848
Provider Enumeration Date:
09/11/2006