Provider First Line Business Practice Location Address:
3315 UNIVERSITY DR
Provider Second Line Business Practice Location Address:
WELLNESS CENTER
Provider Business Practice Location Address City Name:
BISMARCK
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-221-1747
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2017