Provider First Line Business Practice Location Address:
307 3RD ST NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARSHALL
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58770-7109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-862-3242
Provider Business Practice Location Address Fax Number:
701-862-2536
Provider Enumeration Date:
06/27/2012