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General NPI Number Information
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NPI Number | 1760780126
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Entity Type | Organization
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Legal Business Name | WELCORE HEALTH, LLC
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 05/25/2012
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Provider Practice Location Address
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Address Line | 718 OAK ST
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City | GRAND FORKS
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State | ND
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Zip | 58201-4460
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Country | US
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Telephone | 701-746-5359
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Fax | 701-746-5359
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Provider Business Mailing Address
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Address Line | 718 OAK ST
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City | GRAND FORKS
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State | ND
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Zip | 58201-4460
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Country | US
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Telephone | 701-746-5359
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Fax | 701-746-5359
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Authorized Official
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Title or Position | OWNER
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Name | MOLLY J SOEBY
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Credential | MPA, CPHC, MT, SC
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Telephone | 701-746-5359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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