Provider First Line Business Practice Location Address:
FAIRVIEW UNIVERSITY HOSPITAL
Provider Second Line Business Practice Location Address:
2450 RIVERSIDE AVENUE SOUTH
Provider Business Practice Location Address City Name:
MPLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-273-5640
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2006