Provider First Line Business Practice Location Address:
1035 UNIVERSITY DR
Provider Second Line Business Practice Location Address:
236 CENTER FOR RURAL MENTAL HEALTH STUDIES MED SCHOOL
Provider Business Practice Location Address City Name:
DULUTH
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55812-3031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-726-7144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/13/2005