Provider First Line Business Practice Location Address:
1505 3 ST SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-251-1741
Provider Business Practice Location Address Fax Number:
701-252-1207
Provider Enumeration Date:
07/31/2008