LEE A DIEDERICK

FARGO, ND
NPI1699792556
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ND  R15726)
Enumeration Date2006-07-16
Last Update Date2008-09-24
Business Address
LEE A DIEDERICK CRNA
737 BROADWAY
FARGO, ND 58122-0001
Phone number: 701-234-6258
Mailing Address
LEE A DIEDERICK CRNA
737 BROADWAY
FARGO, ND 58122-0001
Phone number: 701-234-6258
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