Provider First Line Business Practice Location Address:
501 COLUMBIA RD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
Provider Business Practice Location Address City Name:
GRAND FORKS
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58202-9037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-777-3240
Provider Business Practice Location Address Fax Number:
701-777-4849
Provider Enumeration Date:
03/23/2006