Provider First Line Business Practice Location Address:
2450 RIVERSIDE AVE SE
Provider Second Line Business Practice Location Address:
EAST BUILDING JOURNEY CLINIC 9E
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:
612-365-8100
Provider Business Practice Location Address Fax Number:
612-365-8101
Provider Enumeration Date:
01/26/2006