Provider First Line Business Practice Location Address:
6700 N. PORT WASHINGTON RD.
Provider Second Line Business Practice Location Address:
ST. FRANCIS CHILDREN'S CENTER
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53217-3919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-351-8850
Provider Business Practice Location Address Fax Number:
414-351-8846
Provider Enumeration Date:
03/19/2007