Provider First Line Business Practice Location Address:
319 MEDICAL GROUP
Provider Second Line Business Practice Location Address:
MENTAL HEALTH CLINIC
Provider Business Practice Location Address City Name:
GRAND FORKS AFB
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-747-4460
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2010