Provider First Line Business Practice Location Address:
2525 CHICAGO AVENUE SOUTH
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITALS AND CLINIC OF MINNESOTA
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-813-6117
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2006