LACEY JO BAKKEN

FARGO, ND
NPI1275193401
Former NameLACEY JO BRILZ
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: ND  1650)
Enumeration Date2019-06-19
Last Update Date2019-06-19
Business Address
LACEY JO BAKKEN OTR/L
5225 23RD AVE S
FARGO, ND 58104-7927
Phone number: 701-417-3400
Mailing Address
LACEY JO BAKKEN OTR/L
5225 23RD AVE S
FARGO, ND 58104-7927
Phone number: 701-417-3400