Provider First Line Business Practice Location Address:
107 W. MAIN AVE. SUITE 225
Provider Second Line Business Practice Location Address:
BISMARCK PSYCHOLOGICAL ASSOCIATES, PLLC
Provider Business Practice Location Address City Name:
BISMARCK
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-751-4122
Provider Business Practice Location Address Fax Number:
701-751-1728
Provider Enumeration Date:
08/31/2006