Provider First Line Business Practice Location Address:
2770 MACKINTOSH LN
Provider Second Line Business Practice Location Address:
B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY
Provider Business Practice Location Address City Name:
BLOOMFIELD HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48302-0933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-743-8086
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2006