Provider First Line Business Practice Location Address:
109 S 9TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKES
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58474-1728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-710-0224
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2026