Provider First Line Business Practice Location Address:
14585 GREENFIELD RD
Provider Second Line Business Practice Location Address:
DETROIT HEALTH DEPARTMENT-GRACE ROSS HEALTH CENTER
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48227-2231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-852-4435
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2007