Provider First Line Business Practice Location Address:
PEDIATRICS 1415 ST FRANCIS AVE
Provider Second Line Business Practice Location Address:
PARK NICOLLET CLINIC-SHAKOPEE
Provider Business Practice Location Address City Name:
SHAKOPEE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-993-7781
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2013