Provider First Line Business Practice Location Address:
451 NORTH DUNLAP ST-MAIL STOP 32700A
Provider Second Line Business Practice Location Address:
HEALTHPARTNERS MIDWAY CLINIC-CENTER FOR INTERNATIONAL H
Provider Business Practice Location Address City Name:
ST. PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55104-2595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-647-2100
Provider Business Practice Location Address Fax Number:
651-647-2201
Provider Enumeration Date:
07/18/2006