Provider First Line Business Practice Location Address:
1400 HIGHWAY 71
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INTERNATIONAL FALLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56649-2154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-653-2528
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2008