Provider First Line Business Practice Location Address:
SINAI GRACE HOSPITAL - ARDMORE CLINIC
Provider Second Line Business Practice Location Address:
14230 WEST MCNICHOLS
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:
313-966-1199
Provider Business Practice Location Address Fax Number:
313-966-4916
Provider Enumeration Date:
06/02/2006