| NPI | 1902158264 |
|---|---|
| Former Legal Business Name | HEALTHSOURCE OF DICKINSON, PLLC |
| Entity Type | Organization |
| Authorized Contact | MARVIN MYRON EBERTS Owner/Operator 701-225-3536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ND 851) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ND 555) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2020-03-31 |