Provider First Line Business Practice Location Address:
732 E LAKE ST
Provider Second Line Business Practice Location Address:
PAIN RELIEF CENTER OF MINNESOTA
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55407-1547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-516-3737
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2011