Provider First Line Business Practice Location Address:
115 4TH AVE SE
Provider Second Line Business Practice Location Address:
FEDERAL BUILDING ROOM 309
Provider Business Practice Location Address City Name:
ABERDEEN
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57401-4310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-226-7726
Provider Business Practice Location Address Fax Number:
605-226-7508
Provider Enumeration Date:
09/10/2007