Healthcare Provider Details

I. General information

NPI: 1467617464
Provider Name (Legal Business Name): ARNTSON ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2008
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 44TH AVE S STE 121D
GRAND FORKS ND
58201-3493
US

IV. Provider business mailing address

620 7TH ST SE
EAST GRAND FORKS MN
56721-2362
US

V. Phone/Fax

Practice location:
  • Phone: 218-779-9736
  • Fax:
Mailing address:
  • Phone: 218-779-9736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number729
License Number StateND

VIII. Authorized Official

Name: MRS. BARBARA ARNTSON
Title or Position: SECRETARY
Credential: MS, RD, LD
Phone: 218-779-9736