Provider First Line Business Practice Location Address:
3901 BEAUBIEN BOULEVARD
Provider Second Line Business Practice Location Address:
DIVISION OF GENETIC AND METABOLIC DISORDERS
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201-2119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-745-2959
Provider Business Practice Location Address Fax Number:
313-745-4827
Provider Enumeration Date:
06/10/2010