Provider First Line Business Practice Location Address:
6050 CLEARWATER DRIVE
Provider Second Line Business Practice Location Address:
CHILDRENS MTKA INDEPENDENT DIAGNOSTIC TESTING FACILITY
Provider Business Practice Location Address City Name:
MINNETONKA
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55343
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-930-8600
Provider Business Practice Location Address Fax Number:
952-930-8650
Provider Enumeration Date:
09/21/2006