Provider First Line Business Practice Location Address:
1500 WEISS ST
Provider Second Line Business Practice Location Address:
(TRAVERSE CITY VA OUTPATIENT CLINIC)
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48602-5251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-932-9720
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2005