Provider First Line Business Practice Location Address:
2525 CHICAGO AVE S
Provider Second Line Business Practice Location Address:
CHILDRENS SPECIALTY CLINIC FEEDING CLINIC MPLS
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-220-6446
Provider Business Practice Location Address Fax Number:
651-220-6860
Provider Enumeration Date:
02/22/2006