Provider First Line Business Practice Location Address:
215 PENNINGTON AVE
Provider Second Line Business Practice Location Address:
PHARMACY
Provider Business Practice Location Address City Name:
THIEF RIVER FALLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56701-2900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-681-1515
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2007