Provider First Line Business Practice Location Address:
301 N 3RD ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
GRAND FORKS
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58203-3519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-775-7725
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2007