Provider First Line Business Practice Location Address:
17807 US HWY 59 NE
Provider Second Line Business Practice Location Address:
ROSE MEDICAL MANAGEMENT
Provider Business Practice Location Address City Name:
THIEF RIVER FALLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56701-5670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-413-5179
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2005