Provider First Line Business Practice Location Address:
2799 WEST GRAND BLVD.
Provider Second Line Business Practice Location Address:
K-8 DEPARTMENT OF GENERAL SURGERY
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-806-0041
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/04/2014