Provider First Line Business Practice Location Address:
307 3RD STREET NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARSHALL
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-862-3138
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2008