Provider First Line Business Practice Location Address:
302 E HOWARD ST
Provider Second Line Business Practice Location Address:
SUITE 18
Provider Business Practice Location Address City Name:
HIBBING
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55746-4215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-263-6439
Provider Business Practice Location Address Fax Number:
218-263-8564
Provider Enumeration Date:
01/02/2007