Provider First Line Business Practice Location Address:
2525 CHICAGO AVENUE SOUTH
Provider Second Line Business Practice Location Address:
32 B852 CHILDRENS HOSPITALS AND CLINICS OF MINNESOTA
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:
612-813-6138
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2007