Provider First Line Business Practice Location Address:
210 FIRST STREET
Provider Second Line Business Practice Location Address:
WANBLEE HEALTH CENTER
Provider Business Practice Location Address City Name:
WANBLEE
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57577-0290
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-462-6155
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2006