Provider First Line Business Practice Location Address:
301 HUNTSINGER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARK RAPIDS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56470-1107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-444-2845
Provider Business Practice Location Address Fax Number:
218-444-2847
Provider Enumeration Date:
11/14/2006