Provider First Line Business Practice Location Address:
800 6TH ST N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAHPETON
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-671-2333
Provider Business Practice Location Address Fax Number:
701-671-3412
Provider Enumeration Date:
08/20/2006