Provider First Line Business Practice Location Address:
9219 WATER STREET
Provider Second Line Business Practice Location Address:
SHORELINE REHAB
Provider Business Practice Location Address City Name:
MONTAGUE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-893-6655
Provider Business Practice Location Address Fax Number:
231-893-4902
Provider Enumeration Date:
11/01/2006