Provider First Line Business Practice Location Address:
151 S 4TH ST, SUITE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND FORKS
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-787-8522
Provider Business Practice Location Address Fax Number:
701-787-5918
Provider Enumeration Date:
05/23/2024