Provider First Line Business Practice Location Address:
345 NORTH SMITH AVENUE
Provider Second Line Business Practice Location Address:
CHILDRENS HOSPITALS & CLINICS OF MN EMERG PHYS STPL
Provider Business Practice Location Address City Name:
ST PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-220-6914
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006