Provider First Line Business Practice Location Address:
3901 BEAUBIEN ER DEPT - GROUND FL
Provider Second Line Business Practice Location Address:
CHILDRENS HOSPITAL MI EMERGENCY MED
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-745-5260
Provider Business Practice Location Address Fax Number:
313-966-0665
Provider Enumeration Date:
06/07/2006