Provider First Line Business Practice Location Address:
HENRY FORD MEDICAL GROUP - DETROIT NORTHWEST
Provider Second Line Business Practice Location Address:
7800 WEST OUTER DRIVE
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:
313-653-2300
Provider Business Practice Location Address Fax Number:
313-653-2660
Provider Enumeration Date:
11/17/2006