Provider First Line Business Practice Location Address:
1500 EAST MEDICAL CENTER
Provider Second Line Business Practice Location Address:
7TH FLOOR MED SUBSPECIALTY CLINIC
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48109-4257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-936-9814
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2016