Provider First Line Business Practice Location Address:
FOND DU LAC HUMAN SERVICES DIVISION
Provider Second Line Business Practice Location Address:
927 TRETTEL LANE
Provider Business Practice Location Address City Name:
CLOQUET
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-879-1227
Provider Business Practice Location Address Fax Number:
218-878-2188
Provider Enumeration Date:
01/16/2007