| NPI | 1134861818 |
|---|---|
| Doing Business As | SKIN REHAB |
| Entity Type | Organization |
| Authorized Contact | AMY LYNN SUDA Owner 701-379-0140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2023-07-13 |