Provider First Line Business Practice Location Address:
4 MAIN, 6071 WEST OUTER DRIVE
Provider Second Line Business Practice Location Address:
SINAI-GRACE HOSPITAL, DEPARTMENT OF INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-989-9250
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2019