Provider First Line Business Practice Location Address:
16001 WEST NINE MILE ROAD
Provider Second Line Business Practice Location Address:
ASCENSION PROVIDENCE HOSPITAL EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48075-4818
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-849-3015
Provider Business Practice Location Address Fax Number:
248-849-2078
Provider Enumeration Date:
06/13/2024