Provider First Line Business Practice Location Address:
CHILDREN'S HOSPITAL OF MI/SPECIALTY CENTER
Provider Second Line Business Practice Location Address:
3950 BEAUBIEN GROUND FLOOR, GARDEN LEVEL
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:
313-745-5437
Provider Business Practice Location Address Fax Number:
313-745-0955
Provider Enumeration Date:
09/07/2012