Provider First Line Business Practice Location Address:
1400 HIGHLAND CTR
Provider Second Line Business Practice Location Address:
ATHLETIC TRAINING - DEPARTMENT OF HUMAN PERFORMANCE
Provider Business Practice Location Address City Name:
MANKATO
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56001-6537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-389-6313
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2016