Provider First Line Business Practice Location Address:
153 CESAR CHAVEZ ST
Provider Second Line Business Practice Location Address:
WESTSIDE COMMUNITY HEALTH SERVICES, INC.
Provider Business Practice Location Address City Name:
W. ST. PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55107-2226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-602-7552
Provider Business Practice Location Address Fax Number:
651-602-7580
Provider Enumeration Date:
03/28/2006