Provider First Line Business Practice Location Address:
516 DELAWARE ST SE, CLINIC 8A
Provider Second Line Business Practice Location Address:
DEPARTMENT OF OTOLARYNGOLOGY/HEAD & NECK SURGERY
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-625-2410
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/05/2006