Provider First Line Business Practice Location Address:
24 9TH ST SE
Provider Second Line Business Practice Location Address:
CENTRACARE CLINIC LONG PRAIRIE
Provider Business Practice Location Address City Name:
LONG PRAIRIE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-732-2131
Provider Business Practice Location Address Fax Number:
320-732-6913
Provider Enumeration Date:
11/02/2005