Provider First Line Business Practice Location Address:
4201 ST ANTOINE STE 5B
Provider Second Line Business Practice Location Address:
DRH ROSA PARKS WELLNESS INSTITUTE FOR SR HEALTH
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:
313-745-1741
Provider Business Practice Location Address Fax Number:
313-745-8165
Provider Enumeration Date:
05/31/2006