Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 6, 2024
License(s)
4351052827 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 19938 FOUNTAIN VIEW LN | Brownstown Twp, MI 48183-1156 | 734-340-8823 |
| LOCATION | 2799 W GRAND BLVD | Detroit, MI 48202-2608 | 734-340-8823 |
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