Provider First Line Business Practice Location Address:
1465 E PARKDALE AVE
Provider Second Line Business Practice Location Address:
CYTOPATHOLOGY/INDEPENDENT LABORATORY
Provider Business Practice Location Address City Name:
MANISTEE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49660-0070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-590-5030
Provider Business Practice Location Address Fax Number:
231-889-5969
Provider Enumeration Date:
08/21/2006