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1710904487
JEFFREY K LYSTAD
FARGO, ND
NPI
1710904487
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207QS0010X Family Medicine, Sports Medicine
(Licence: ND 7448)
Enumeration Date
2006-07-17
Last Update Date
2011-11-29
Business Address
JEFFREY K LYSTAD MD
2301 25TH ST S
FARGO, ND 58103-6104
Phone number: 701-237-9712
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Mailing Address
JEFFREY K LYSTAD MD
2301 25TH ST S
FARGO, ND 58103-6104
Phone number: 701-237-9712
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