Provider First Line Business Practice Location Address:
13437 SCHAEFER HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48227-3538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-270-2709
Provider Business Practice Location Address Fax Number:
313-270-2720
Provider Enumeration Date:
01/26/2016