Provider First Line Business Practice Location Address:
3990 JOHN R, 7 BRUSH NORTH
Provider Second Line Business Practice Location Address:
WAYNE STATE UNIVERSITY/ DETROIT MEDICAL CENTER,OBGYN
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:
734-444-6406
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2008