Provider First Line Business Practice Location Address:
CHILDREN'S HOSPITAL OF MI
Provider Second Line Business Practice Location Address:
3901 BEAUBIEN 2ND FLR - MAIN BUILDING
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:
313-993-8829
Provider Business Practice Location Address Fax Number:
313-993-7124
Provider Enumeration Date:
06/27/2006