Provider First Line Business Practice Location Address:
15800 95TH AVE N
Provider Second Line Business Practice Location Address:
REHAB
Provider Business Practice Location Address City Name:
MAPLE GROVE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55369-4400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-993-1477
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006