Provider First Line Business Practice Location Address:
NORTHEAST HEALTH CENTER 5400 EAST 7 MILE ROAD
Provider Second Line Business Practice Location Address:
ROOM 16
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-870-3049
Provider Business Practice Location Address Fax Number:
313-368-4694
Provider Enumeration Date:
07/10/2008