Provider First Line Business Practice Location Address:
2900 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
SPORTS CENTER
Provider Business Practice Location Address City Name:
CROOKSTON
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56716-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-281-8427
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2016