Provider First Line Business Practice Location Address:
200 HENRY CLAY
Provider Second Line Business Practice Location Address:
CHILDRENS HOSPITAL
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-896-9418
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2006