Provider First Line Business Practice Location Address:
9055 SPRINGBROOK DR
Provider Second Line Business Practice Location Address:
ALLINA MEDICAL CLINIC - COON RAPIDS
Provider Business Practice Location Address City Name:
COON RAPIDS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-780-9155
Provider Business Practice Location Address Fax Number:
763-236-1233
Provider Enumeration Date:
09/01/2005