Provider First Line Business Practice Location Address:
8170 33RD AVE S, C/O PHYSICIAN SERVICES
Provider Second Line Business Practice Location Address:
MS 21110Q, HEALTHPARTNERS FLOATING CLINIC
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55440-1309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-883-5375
Provider Business Practice Location Address Fax Number:
952-883-5395
Provider Enumeration Date:
03/19/2008