Provider First Line Business Practice Location Address:
HENRY FORD HEALTH SYSTEM
Provider Second Line Business Practice Location Address:
6777 WEST MAPLE ROAD
Provider Business Practice Location Address City Name:
WEST BLOOMFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-661-6450
Provider Business Practice Location Address Fax Number:
248-661-6649
Provider Enumeration Date:
12/18/2006