Healthcare Provider Details

I. General information

NPI: 1477442754
Provider Name (Legal Business Name): COLE WUERDEMANN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3306 SHEYENNE ST STE 210
WEST FARGO ND
58078-7211
US

IV. Provider business mailing address

3240 15TH ST S STE C
FARGO ND
58104-6188
US

V. Phone/Fax

Practice location:
  • Phone: 701-970-2080
  • Fax: 701-970-2079
Mailing address:
  • Phone: 701-451-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1227
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: