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General NPI Number Information
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NPI Number | 1215080437
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NORTH DAKOTA
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 12/12/2017
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Provider Practice Location Address
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Address Line | 2751 2ND AVE N STOP 9013 HYSLOP SPORTS CENTER ROOM 115
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City | GRAND FORKS
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State | ND
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Zip | 58202-9013
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Country | US
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Telephone | 701-777-6572
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Fax | 701-777-2536
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Provider Business Mailing Address
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Address Line | 2751 2ND AVE N STOP 9013 HYSLOP SPORTS CENTER ROOM 115
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City | GRAND FORKS
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State | ND
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Zip | 58202-9013
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Country | US
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Telephone | 701-777-6572
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Fax | 701-777-2536
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Authorized Official
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Title or Position | ADMIN
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Name | KATRINA LANDMAN
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Credential |
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Telephone | 701-777-4845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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