Provider First Line Business Practice Location Address:
16588 SCHAEFER HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48235-4249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-345-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/20/2026