Provider First Line Business Practice Location Address:
2450 RIVERSIDE AVE
Provider Second Line Business Practice Location Address:
JOURNEY CLINIC, 9TH FLOOR, EAST BUILDING
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55454-1450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-365-8100
Provider Business Practice Location Address Fax Number:
612-365-8101
Provider Enumeration Date:
06/04/2007