Provider First Line Business Practice Location Address:
20 SE NINTH STREET
Provider Second Line Business Practice Location Address:
CENTRACARE HEALTH SYSTEM-LONG PRAIRIE
Provider Business Practice Location Address City Name:
LONG PRAIRIE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56347-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-732-2141
Provider Business Practice Location Address Fax Number:
320-732-6913
Provider Enumeration Date:
01/25/2007