Provider First Line Business Practice Location Address:
2024 SOUTH SIXTH STREET
Provider Second Line Business Practice Location Address:
BRAINERD MEDICAL CENTER
Provider Business Practice Location Address City Name:
BRAINERD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-828-2880
Provider Business Practice Location Address Fax Number:
218-828-7107
Provider Enumeration Date:
07/14/2005