Provider First Line Business Practice Location Address:
B228 LIFE SCIENCE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48824-1317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-432-3467
Provider Business Practice Location Address Fax Number:
517-353-5436
Provider Enumeration Date:
11/08/2006