Provider First Line Business Practice Location Address:
7373 W 147TH ST
Provider Second Line Business Practice Location Address:
DAKOTA VALLEY PSYCHOLOGISTS STE 180
Provider Business Practice Location Address City Name:
APPLE VALLEY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-432-3220
Provider Business Practice Location Address Fax Number:
952-891-4622
Provider Enumeration Date:
02/14/2007