Provider First Line Business Practice Location Address:
576 APOLLO DR - MS 39603A
Provider Second Line Business Practice Location Address:
NORTH SUBURBAN FAMILY PHYSICIANS
Provider Business Practice Location Address City Name:
LINO LAKES
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55014-3004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-486-2320
Provider Business Practice Location Address Fax Number:
651-486-2321
Provider Enumeration Date:
04/09/2008