Provider First Line Business Practice Location Address:
37 SOUTH COLLEGE AVENUE
Provider Second Line Business Practice Location Address:
C/O CSB HEALTH CENTER, LOTTIE HALL LOWER LEVEL
Provider Business Practice Location Address City Name:
ST. JOSEPH
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-363-5605
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2012