Healthcare Provider Details

I. General information

NPI: 1598849184
Provider Name (Legal Business Name): DION S. FICEK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 1/2 12TH ST. W
DICKINSON ND
58601-3509
US

IV. Provider business mailing address

562 1/2 12TH ST. W
DICKINSON ND
58601-3509
US

V. Phone/Fax

Practice location:
  • Phone: 701-483-8824
  • Fax: 701-483-1443
Mailing address:
  • Phone: 701-483-8824
  • Fax: 701-483-1443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number638
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: