Provider First Line Business Practice Location Address:
570 CLINTON ST
Provider Second Line Business Practice Location Address:
ANDREW BAIRD DETENTION FACILITY
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48226-2334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-224-0435
Provider Business Practice Location Address Fax Number:
313-224-0713
Provider Enumeration Date:
11/11/2010