Provider First Line Business Practice Location Address:
DETROIT RECEIVING PSYCHIATRY
Provider Second Line Business Practice Location Address:
4201 ST ANTOINE UNIT 5V
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-966-7544
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2006