Provider First Line Business Practice Location Address:
640 JACKSON STREET MS 11101A
Provider Second Line Business Practice Location Address:
HEALTHPARTNERS REGIONS SPECIALTY CLINICS
Provider Business Practice Location Address City Name:
SAINT PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-254-4600
Provider Business Practice Location Address Fax Number:
651-254-4639
Provider Enumeration Date:
11/27/2009