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1275193401
LACEY JO BAKKEN
FARGO, ND
NPI
1275193401
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Former Name
LACEY JO BRILZ
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ND 1650)
Enumeration Date
2019-06-19
Last Update Date
2019-06-19
Business Address
LACEY JO BAKKEN OTR/L
5225 23RD AVE S
FARGO, ND 58104-7927
Phone number: 701-417-3400
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Mailing Address
LACEY JO BAKKEN OTR/L
5225 23RD AVE S
FARGO, ND 58104-7927
Phone number: 701-417-3400
Copy
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