Provider First Line Business Practice Location Address:
328 W. CONAN ST.
Provider Second Line Business Practice Location Address:
ELY BLOOMESON COMMUNITY HOSPITAL
Provider Business Practice Location Address City Name:
ELY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55731-1145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-365-8770
Provider Business Practice Location Address Fax Number:
218-365-8746
Provider Enumeration Date:
09/21/2011