Provider First Line Business Practice Location Address:
1300 HOSPITAL LOOP
Provider Second Line Business Practice Location Address:
HOSPITAL ROAD
Provider Business Practice Location Address City Name:
BELCOURT
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-477-6111
Provider Business Practice Location Address Fax Number:
701-477-2507
Provider Enumeration Date:
01/05/2007