Provider First Line Business Practice Location Address:
VA MEDICAL CENTER, ROUTE 122
Provider Second Line Business Practice Location Address:
ONE VETERANS DRIVE
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:
612-467-3239
Provider Business Practice Location Address Fax Number:
612-725-2126
Provider Enumeration Date:
05/23/2006