Provider First Line Business Practice Location Address:
520 5TH STREET NW
Provider Second Line Business Practice Location Address:
NORTHERN PINES MENTAL HEALTH
Provider Business Practice Location Address City Name:
BRAINERD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56401-5700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-829-3235
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/29/2017