Provider First Line Business Practice Location Address:
17126 SCHAEFER HWY
Provider Second Line Business Practice Location Address:
PHARMACY DEPT
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48235-4131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-341-0606
Provider Business Practice Location Address Fax Number:
313-341-0610
Provider Enumeration Date:
02/14/2007