Provider First Line Business Practice Location Address:
215 NORTH AVE
Provider Second Line Business Practice Location Address:
ST JOSEPH SPECIALTY HOSPITAL 215
Provider Business Practice Location Address City Name:
MT CLEMENS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-466-9889
Provider Business Practice Location Address Fax Number:
586-466-9972
Provider Enumeration Date:
07/12/2006