Provider First Line Business Practice Location Address:
4201 ST. ANTOINE, 9D
Provider Second Line Business Practice Location Address:
HEALTH CENTERS DETROIT MEDICAL GROUP
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:
313-966-5187
Provider Business Practice Location Address Fax Number:
313-966-8111
Provider Enumeration Date:
06/02/2006