Provider First Line Business Practice Location Address:
500 HARVARD ST.
Provider Second Line Business Practice Location Address:
FAIRVIEW UNIVERSITY HOSPITAL
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:
608-469-0217
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2011