Provider First Line Business Practice Location Address:
1000 SOUTH COLUMBIA ROAD
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:
58206-6002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-780-5000
Provider Business Practice Location Address Fax Number:
701-780-1942
Provider Enumeration Date:
08/05/2006