Provider First Line Business Practice Location Address:
4201 ST. ANTOINE ST
Provider Second Line Business Practice Location Address:
DETROIT EDUCATION AND RESEARCH, GRADUATE MEDICAL EDUCAT
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-993-0034
Provider Business Practice Location Address Fax Number:
313-966-0880
Provider Enumeration Date:
04/26/2016