Provider First Line Business Practice Location Address:
20 SE NINTH STREET
Provider Second Line Business Practice Location Address:
CENTRA CARE HEALTH SYSTEM- LONG PRAIRE
Provider Business Practice Location Address City Name:
LONG PRAIRIE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56347-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-732-2141
Provider Business Practice Location Address Fax Number:
320-732-3802
Provider Enumeration Date:
05/15/2006