Provider First Line Business Practice Location Address:
2024 SOUTH 6TH ST
Provider Second Line Business Practice Location Address:
CLINIC PHARMACY
Provider Business Practice Location Address City Name:
BRAINERD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-829-7455
Provider Business Practice Location Address Fax Number:
218-855-5205
Provider Enumeration Date:
12/13/2007