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1225697899
CANDACE MARIE VANDER WAL
BISMARCK, ND
NPI
1225697899
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: ND 683-15)
Enumeration Date
2019-06-07
Last Update Date
2019-06-07
Business Address
CANDACE MARIE VANDER WAL MS, LAT, ATC, CSCS
3451 N 14TH ST STE C
BISMARCK, ND 58503-1611
Phone number: 701-323-1125
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Mailing Address
CANDACE MARIE VANDER WAL MS, LAT, ATC, CSCS
3451 N 14TH ST STE C
BISMARCK, ND 58503-1611
Phone number: 701-323-1125
Copy
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