Provider First Line Business Practice Location Address:
213 N 9TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKES
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58474-1305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-742-3274
Provider Business Practice Location Address Fax Number:
701-742-3317
Provider Enumeration Date:
11/03/2005