Provider First Line Business Practice Location Address:
2450 RIVERSIDE AVENUE SE PSYCHIATRY CLINIC
Provider Second Line Business Practice Location Address:
UNIVERSITY OF MINNESOTA MEDICAL CENTRE, FAIRVIEW
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-626-6773
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2013