Provider First Line Business Practice Location Address:
CHILDRENS HOSPITAL OF WI GENETICS CENTER
Provider Second Line Business Practice Location Address:
8915 W CONNELL CT, STA 716
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226-5322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-266-2031
Provider Business Practice Location Address Fax Number:
414-266-2031
Provider Enumeration Date:
05/11/2020