Provider First Line Business Practice Location Address:
3448 LAKE LANSING ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-333-4440
Provider Business Practice Location Address Fax Number:
517-333-7173
Provider Enumeration Date:
04/26/2007