Provider First Line Business Practice Location Address:
INTERSTATE 29 & 13TH AVENUE SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARGO
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-277-9555
Provider Business Practice Location Address Fax Number:
701-277-7112
Provider Enumeration Date:
01/03/2007