Provider First Line Business Practice Location Address:
905 EAST INTERSTATE AVE.
Provider Second Line Business Practice Location Address:
NEW FREEDOM CENTER, INC.
Provider Business Practice Location Address City Name:
BISMARCK
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-222-4673
Provider Business Practice Location Address Fax Number:
701-222-3947
Provider Enumeration Date:
08/25/2009