Provider First Line Business Practice Location Address:
911 NORTHLAND DRIVE
Provider Second Line Business Practice Location Address:
FAIRVIEW NORTHLAND MEDICAL CENTER
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-389-6396
Provider Business Practice Location Address Fax Number:
763-389-6395
Provider Enumeration Date:
09/07/2007