Provider First Line Business Practice Location Address: 
24100 DRAKE RD SUITE B
    Provider Second Line Business Practice Location Address: 
THERAPY UNLIMITED
    Provider Business Practice Location Address City Name: 
FARMINGTON
    Provider Business Practice Location Address State Name: 
MI
    Provider Business Practice Location Address Postal Code: 
48335
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
248-442-5011
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
10/27/2011