Provider First Line Business Practice Location Address:
2255 FORT ST
Provider Second Line Business Practice Location Address:
INDEX PARK PHARMACY
Provider Business Practice Location Address City Name:
LINCOLN PARK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48146-2671
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-357-7500
Provider Business Practice Location Address Fax Number:
313-347-8998
Provider Enumeration Date:
09/30/2013