Provider First Line Business Practice Location Address:
14 N 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKES
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58474-1209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-742-2750
Provider Business Practice Location Address Fax Number:
701-742-2909
Provider Enumeration Date:
09/20/2006