Provider First Line Business Practice Location Address:
3031 WEST GRAND BOULEVARD
Provider Second Line Business Practice Location Address:
HENRY FORD HOSPITAL ENDOCRINOLOGY
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48202-3141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-916-2127
Provider Business Practice Location Address Fax Number:
313-916-8343
Provider Enumeration Date:
01/31/2007