Provider First Line Business Practice Location Address:
104 1ST ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KARLSTAD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-436-3161
Provider Business Practice Location Address Fax Number:
218-436-3162
Provider Enumeration Date:
01/24/2007