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1023556131
STACI RAE BLEECKER
LISBON, ND
NPI
1023556131
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: ND 1260)
Enumeration Date
2017-02-09
Last Update Date
2019-11-12
Business Address
MISS STACI RAE BLEECKER COTA/L
905 MAIN ST
LISBON, ND 58054-4334
Phone number: 701-683-6402
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Mailing Address
MISS STACI RAE BLEECKER COTA/L
11 N MAIN ST
GWINNER, ND 58040-4001
Phone number: 701-678-2244
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