Provider First Line Business Practice Location Address:
316 2ND AVE W
Provider Second Line Business Practice Location Address:
NORTHWEST HUMAN SERVICES CENTER
Provider Business Practice Location Address City Name:
WILLISTON
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-774-4600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/09/2014