Provider First Line Business Practice Location Address:
100 W. ARGYLE STREET
Provider Second Line Business Practice Location Address:
SANILAC MEDICAL PLAZA
Provider Business Practice Location Address City Name:
SANDUSKY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-648-6113
Provider Business Practice Location Address Fax Number:
810-648-0262
Provider Enumeration Date:
02/21/2006