| NPI | 1427152115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI LYNN SHEPHERD Insurance Coordinator 701-231-5239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND 168) |
| 291U00000X Clinical Medical Laboratory (Licence: ND 95503681) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2018-10-23 |