Provider First Line Business Practice Location Address:
1VETERANS DRIVE, SURGICAL SERVICE/112
Provider Second Line Business Practice Location Address:
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:
612-725-2065
Provider Business Practice Location Address Fax Number:
612-725-2227
Provider Enumeration Date:
10/03/2006