Provider First Line Business Practice Location Address:
206 SCHOOL ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATESLAND
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57716-0109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-288-1921
Provider Business Practice Location Address Fax Number:
605-288-1814
Provider Enumeration Date:
02/25/2009