| NPI | 1558305839 |
|---|---|
| Doing Business As | GLEN ULLIN CLINIC ELGIN CLINIC |
| Entity Type | Organization |
| Authorized Contact | GEORGE STEPHAN HSU Owner 701-584-3010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: ND 3068) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ND 561) |
| 363A00000X Physician Assistant (Licence: ND PAC0361) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ND R17917) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2008-04-16 |