MADISON LAKE

GRAND FORKS, ND
NPI1629656806
Former NameMADISON BAKKEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2021-03-30
Last Update Date2026-06-19
Business Address
MADISON LAKE PA-C
1108 S 9TH ST
GRAND FORKS, ND 58201-5570
Phone number: 218-689-9517
Mailing Address
MADISON LAKE PA-C
1108 S 9TH ST
GRAND FORKS, ND 58201-5570
Phone number: 218-689-9517
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