Provider First Line Business Practice Location Address:
VA MEDICAL CENTER (116B)
Provider Second Line Business Practice Location Address:
ONE VETERANS DRIVE
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-467-4024
Provider Business Practice Location Address Fax Number:
612-727-5964
Provider Enumeration Date:
05/10/2006