Provider First Line Business Practice Location Address:
801 W. CENTRAL ENTRANCE
Provider Second Line Business Practice Location Address:
SHOPKO PHARMACY 2114
Provider Business Practice Location Address City Name:
DULUTH
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-727-7139
Provider Business Practice Location Address Fax Number:
218-727-6240
Provider Enumeration Date:
03/25/2014