Provider First Line Business Mailing Address:
915 E. 1ST ST.
Provider Second Line Business Mailing Address:
CBO-DENFIELD, ATTN: CREDENTIALING
Provider Business Mailing Address City Name:
DULUTH
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55805-2107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-249-6839
Provider Business Mailing Address Fax Number:
218-249-6880