Provider First Line Business Practice Location Address:
20041 WEST EIGHT MILE ROAD
Provider Second Line Business Practice Location Address:
NORTH CLINIC, P.C.
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-532-5030
Provider Business Practice Location Address Fax Number:
313-532-0552
Provider Enumeration Date:
12/03/2009