Provider First Line Business Practice Location Address:
4201 ST. ANTOINE STREET
Provider Second Line Business Practice Location Address:
UHC - 9C
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-581-5900
Provider Business Practice Location Address Fax Number:
248-581-5647
Provider Enumeration Date:
06/05/2013