Provider First Line Business Practice Location Address:
2799 W GRAND BOULEVARD
Provider Second Line Business Practice Location Address:
MEDICAL EDUCATION DEPARTMENT
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48202-2689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-436-7936
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2017