Provider First Line Business Practice Location Address:
ABBOTT RD
Provider Second Line Business Practice Location Address:
HEALTH SERVICES, EDC
Provider Business Practice Location Address City Name:
MIDLAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48674-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-636-2106
Provider Business Practice Location Address Fax Number:
989-636-7431
Provider Enumeration Date:
03/27/2007