Provider First Line Business Practice Location Address:
516 DELAWARE STREET SE
Provider Second Line Business Practice Location Address:
PWB 1ST FL CINIC 1D UNIVERSITY OF MINNESOTA PHYSICIANS
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:
612-273-6004
Provider Business Practice Location Address Fax Number:
612-273-8459
Provider Enumeration Date:
07/05/2006