Provider First Line Business Practice Location Address:
101 N MAIN ST
Provider Second Line Business Practice Location Address:
SNYDER DRUG 5008
Provider Business Practice Location Address City Name:
PARK RAPIDS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-732-3342
Provider Business Practice Location Address Fax Number:
218-732-5053
Provider Enumeration Date:
12/03/2008