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| Type | Address | [sources] | |||
|---|---|---|---|---|---|
| Country | United States | [sources] | |||
| City | FOREST LAKE | [sources] | |||
| Full address | 631 LAKE ST S, FOREST LAKE, MN 55025 | [sources] | |||
| Postal code | 55025 | [sources] | |||
| State | MN | [sources] | |||
| Street address | 631 LAKE ST S | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended or terminated from Minnesota Health Care Programs.
United States · MHCP
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