Provider First Line Business Practice Location Address:
319TH MEDICAL GROUP
Provider Second Line Business Practice Location Address:
1599 J STREET
Provider Business Practice Location Address City Name:
GRAND FORKS AFB
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58204-9332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-747-5547
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2013