Provider First Line Business Practice Location Address:
SINAI - GRACE HOSPITAL, 6071 OUTER DRIVE W
Provider Second Line Business Practice Location Address:
DEPARTMENT OF MEDICINE - 4 MAIN
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:
313-966-1003
Provider Business Practice Location Address Fax Number:
313-966-1738
Provider Enumeration Date:
06/24/2019