Provider First Line Business Practice Location Address:
337 E HOUGHTON AVE
Provider Second Line Business Practice Location Address:
CLINIC A
Provider Business Practice Location Address City Name:
WEST BRANCH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48661-1127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-329-1244
Provider Business Practice Location Address Fax Number:
989-345-3715
Provider Enumeration Date:
11/22/2013