Provider First Line Business Practice Location Address:
CHILDREN'S HOSPITAL OF MICHIGAN 3901 BEAUBIEN ST
Provider Second Line Business Practice Location Address:
PEDIATRIC EDUCATION OFFICE 3RD FLOOR MAIN HOSPITAL 3T72
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:
313-745-1892
Provider Business Practice Location Address Fax Number:
313-993-7118
Provider Enumeration Date:
04/30/2020