Provider First Line Business Practice Location Address:
602 MAIN ST. E
Provider Second Line Business Practice Location Address:
GOOD SAMARITAN CENTER
Provider Business Practice Location Address City Name:
MOHALL
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-756-6831
Provider Business Practice Location Address Fax Number:
701-756-6357
Provider Enumeration Date:
02/08/2010