Provider First Line Business Practice Location Address:
610 SOUTH 18TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND FORKS
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-757-0537
Provider Business Practice Location Address Fax Number:
701-757-4024
Provider Enumeration Date:
06/05/2024