Provider First Line Business Practice Location Address: 
1200 E. MICHIGAN AVE
    Provider Second Line Business Practice Location Address: 
OUTPATIENT REHAB - LOWER LEVEL
    Provider Business Practice Location Address City Name: 
LANSING
    Provider Business Practice Location Address State Name: 
MI
    Provider Business Practice Location Address Postal Code: 
48912
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
517-364-5252
    Provider Business Practice Location Address Fax Number: 
517-364-5296
    Provider Enumeration Date: 
02/26/2015