Provider First Line Business Practice Location Address:
347 NORTH SMITH AVENUE
Provider Second Line Business Practice Location Address:
CHILDRENS SPECIALITY CLINIC NICU
Provider Business Practice Location Address City Name:
ST PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-220-6210
Provider Business Practice Location Address Fax Number:
651-220-7777
Provider Enumeration Date:
04/19/2006