Provider First Line Business Practice Location Address: 
7590 LYRIC LANE NE
    Provider Second Line Business Practice Location Address: 
UNITY HOSPITAL
    Provider Business Practice Location Address City Name: 
FRIDLEY
    Provider Business Practice Location Address State Name: 
MN
    Provider Business Practice Location Address Postal Code: 
55432
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
763-236-9300
    Provider Business Practice Location Address Fax Number: 
763-236-4370
    Provider Enumeration Date: 
10/05/2006