Provider First Line Business Practice Location Address:
1310 HOSPITAL LOOP ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELCOURT
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-477-5915
Provider Business Practice Location Address Fax Number:
701-857-5117
Provider Enumeration Date:
04/03/2007