Provider First Line Business Practice Location Address:
11800 E 12 MILE ROAD
Provider Second Line Business Practice Location Address:
ST JOHN MACOMB HOSPITAL DEPT OF EMERGENCY MEDICINE
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-573-5059
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2006