Provider First Line Business Practice Location Address:
316 MAIN ST
Provider Second Line Business Practice Location Address:
PHS INDIAN HOSPITAL
Provider Business Practice Location Address City Name:
EAGLE BUTTE
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57625-0590
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-964-7830
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2008