Provider First Line Business Practice Location Address:
1430 HWY 96 E - MAIL STOP 32300A
Provider Second Line Business Practice Location Address:
HEALTHPARTNERS WHITE BEAR LAKE CLINIC
Provider Business Practice Location Address City Name:
WHITE BEAR LAKE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55110-7693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-426-1980
Provider Business Practice Location Address Fax Number:
651-653-2111
Provider Enumeration Date:
02/22/2006