Provider First Line Business Practice Location Address:
3000 32ND AVENUE SOUTH
Provider Second Line Business Practice Location Address:
ESSENTIA HEALTH 32ND AVENUE CLINIC
Provider Business Practice Location Address City Name:
FARGO
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58103-6132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-364-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2006