Provider First Line Business Practice Location Address:
901 8TH ST. S
Provider Second Line Business Practice Location Address:
CONCORDIA HEALTH SERVICES
Provider Business Practice Location Address City Name:
MOORHEAD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-299-3662
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/06/2006