Provider First Line Business Practice Location Address:
4201 ST. ANTOINE, 2E-UHC
Provider Second Line Business Practice Location Address:
DEPARTMENT OF INTERNAL MEDICINE, WSU/DETROIT MEDICAL CE
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:
313-745-4984
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/24/2009