Provider First Line Business Practice Location Address:
1465 E PARKDALE AVE
Provider Second Line Business Practice Location Address:
PATHOLOGY SERVICES.ORG LLC ATTN LISA WORLEY
Provider Business Practice Location Address City Name:
MANISTEE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-590-5030
Provider Business Practice Location Address Fax Number:
231-889-8969
Provider Enumeration Date:
01/08/2007