Provider First Line Business Practice Location Address:
DETROIT MEDICAL CENTER - SINAI GRACE HOSPITAL, DEPARTME
Provider Second Line Business Practice Location Address:
6071 WEST OUTER DRIVE
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-966-7434
Provider Business Practice Location Address Fax Number:
313-966-1738
Provider Enumeration Date:
05/13/2020