Provider First Line Business Practice Location Address:
CITY OF DETROIT HEALTH DEPARTMENT 1151 TAYLOR
Provider Second Line Business Practice Location Address:
ROOM 332
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48202-1732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-852-4291
Provider Business Practice Location Address Fax Number:
313-368-4694
Provider Enumeration Date:
07/11/2008