Provider First Line Business Practice Location Address:
701 PARK AVE
Provider Second Line Business Practice Location Address:
HENNEPIN COUNTY MEDICAL CENTER, EMERGENCY MEDICINE
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-837-5645
Provider Business Practice Location Address Fax Number:
612-904-4241
Provider Enumeration Date:
05/25/2010