Provider First Line Business Practice Location Address:
UPC CHILDREN'S HOSPITAL
Provider Second Line Business Practice Location Address:
3901 BEAUBIEN 4TH FLOOR CARLS BLDG
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:
313-745-4878
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2006