Provider First Line Business Practice Location Address:
3950 BEAUBIEN
Provider Second Line Business Practice Location Address:
CHILDREN'S SPECIALTY CLINIC
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201-2169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-253-9525
Provider Business Practice Location Address Fax Number:
313-966-7478
Provider Enumeration Date:
06/30/2006