Provider First Line Business Practice Location Address:
13534 STATE HIGHWAY 28
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWBERRY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49868
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
906-293-3556
Provider Business Practice Location Address Fax Number:
906-293-8945
Provider Enumeration Date:
12/03/2008