Provider First Line Business Practice Location Address:
4201 ANTOINE, STREET, DETROIT MEDICAL CENTER
Provider Second Line Business Practice Location Address:
MICHAEL AND MARIAN ILLITCH DEPARTMENT OF SURGERY
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:
647-774-3580
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2019