Provider First Line Business Practice Location Address:
PHYSICAL MEDICINE AND REHABILATION AND PAIN CONSULTANT
Provider Second Line Business Practice Location Address:
17117 WEST NINE MILE ROAD SUITE 1331
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-552-9233
Provider Business Practice Location Address Fax Number:
248-552-9244
Provider Enumeration Date:
09/29/2006