Provider First Line Business Practice Location Address:
211 WEST FOURTH STREET
Provider Second Line Business Practice Location Address:
CENTER FOR AMERICAN INDIAN RESOURCES
Provider Business Practice Location Address City Name:
DULUTH
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-726-1370
Provider Business Practice Location Address Fax Number:
218-878-3755
Provider Enumeration Date:
08/18/2010