Provider First Line Business Practice Location Address:
2450 RISNER DRIVE
Provider Second Line Business Practice Location Address:
ELLSWORTH AIR FORCE BASE HEALTH AND WELLNESS CENTER
Provider Business Practice Location Address City Name:
ELLSWORTH AFB
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-385-2349
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2008