SAMMANTHA JEANE KOUBA

FARGO, ND
NPI1760877344
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207RI0200X Internal Medicine, Infectious Disease
(Licence: ND  16710)
Additional Taxonomies207R00000X Internal Medicine
(Licence: IA  DO-05366)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: OR  PG172349)
Enumeration Date2015-04-01
Last Update Date2022-04-19
Business Address
SAMMANTHA JEANE KOUBA DO
5225 23RD AVE S
FARGO, ND 58104-7927
Phone number: 701-417-2575
Mailing Address
SAMMANTHA JEANE KOUBA DO
PO BOX 5074
SIOUX FALLS, SD 57117-5074
Phone number: