| NPI | 1831312750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTELL MARIE TWOBEARS President 701-499-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 7807) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R28446) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-08-27 |