Provider First Line Business Practice Location Address:
4201 ST ANTOINE STE 4E&F
Provider Second Line Business Practice Location Address:
UNIVERSITY HEALTH CENTER
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-745-4380
Provider Business Practice Location Address Fax Number:
313-993-0692
Provider Enumeration Date:
06/06/2006