Provider First Line Business Practice Location Address:
5353 GAMBLE DRIVE SUITE 202
Provider Second Line Business Practice Location Address:
TEAM SPINE
Provider Business Practice Location Address City Name:
ST. LOUIS PARK
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-697-5095
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2011