Provider First Line Business Practice Location Address:
1400 HWY 71
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INTERNATIONAL FALLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56649-2189
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-598-5665
Provider Business Practice Location Address Fax Number:
218-598-5329
Provider Enumeration Date:
03/24/2014