Provider First Line Business Practice Location Address:
2799 W GRAND BLVD, CFP-505
Provider Second Line Business Practice Location Address:
DIVISION OF NEPHROLOGY, HENRY FORD HEALTH SYSTEM
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:
313-916-2710
Provider Business Practice Location Address Fax Number:
313-916-2554
Provider Enumeration Date:
11/09/2006