Provider First Line Business Practice Location Address:
ALEX NEMZEK HALL
Provider Second Line Business Practice Location Address:
1104 SEVENTH AVENUE SOUTH
Provider Business Practice Location Address City Name:
MOORHEAD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56563-5600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-477-2318
Provider Business Practice Location Address Fax Number:
218-477-2363
Provider Enumeration Date:
06/28/2006