Provider First Line Business Practice Location Address:
2799 W. GRAND BLVD
Provider Second Line Business Practice Location Address:
HENRY FORD DEPT OF RADIOLOGY
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48202-2689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-916-7425
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2006