Provider First Line Business Practice Location Address:
830 W LAKE LANSING RD
Provider Second Line Business Practice Location Address:
200
Provider Business Practice Location Address City Name:
EAST LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48823-6372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-624-1416
Provider Business Practice Location Address Fax Number:
517-237-4170
Provider Enumeration Date:
09/26/2023