Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Aug 19, 2011
License(s)
4301098566 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2799 W GRAND BLVD | Detroit, MI 48202-2608 | 313-916-2600 |
| LOCATION | 2799 W GRAND BLVD HENRY FORD HOSPITAL | Detroit, MI 48202-2608 | 313-916-2171 |
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