Provider First Line Business Practice Location Address:
7500 80TH STREET SOUTH, SUITE 100 - MAIL STOP 34624A
Provider Second Line Business Practice Location Address:
HEALTHPARTNERS COTTAGE GROVE CLINIC
Provider Business Practice Location Address City Name:
COTTAGE GROVE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55016-3008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-415-4100
Provider Business Practice Location Address Fax Number:
651-415-4101
Provider Enumeration Date:
10/29/2007