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1740005941
VIATCHESLAV FATYUKHIN
FARGO, ND
NPI
1740005941
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2024-11-21
Last Update Date
2024-11-21
Business Address
VIATCHESLAV FATYUKHIN
1202 WESTRAC DR S STE 400
FARGO, ND 58103-2356
Phone number: 701-280-9545
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Mailing Address
VIATCHESLAV FATYUKHIN
1202 WESTRAC DR S STE 400
FARGO, ND 58103-2356
Phone number: 701-280-9545
Copy
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