Provider First Line Business Practice Location Address:
2220 RIVERSIDE AVE
Provider Second Line Business Practice Location Address:
MC 21110Q HEALTHPARTNERS RIVERSIDE CLINIC
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55454-1321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-883-6805
Provider Business Practice Location Address Fax Number:
952-883-6117
Provider Enumeration Date:
10/22/2012