Provider First Line Business Practice Location Address:
500 UNIVERSITY AVENUE WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINOT
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-858-3030
Provider Business Practice Location Address Fax Number:
701-858-3032
Provider Enumeration Date:
12/19/2006