Provider First Line Business Practice Location Address:
1000 5TH ST N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARRINGTON
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58421-1113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-652-2221
Provider Business Practice Location Address Fax Number:
701-652-2207
Provider Enumeration Date:
06/26/2014