Provider First Line Business Practice Location Address:
19160 GREENFIELD ROAD
Provider Second Line Business Practice Location Address:
RITE AID PHARMACY
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-862-2603
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/30/2014