Provider First Line Business Practice Location Address:
423 FRONT ST NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARNESVILLE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-354-2148
Provider Business Practice Location Address Fax Number:
218-354-2168
Provider Enumeration Date:
08/21/2006