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General NPI Number Information
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NPI Number | 1861540064
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Entity Type | Organization
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Legal Business Name | MILESTONE THERAPEUTICS INC
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Dates
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Enumeration Date | 01/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 921 43RD AVE N
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City | FARGO
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State | ND
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Zip | 58102-5320
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Country | US
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Telephone | 701-793-3646
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Fax | 701-293-6892
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Provider Business Mailing Address
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Address Line | 921 43RD AVE N
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City | FARGO
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State | ND
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Zip | 58102-5320
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Country | US
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Telephone | 701-793-3646
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Fax | 701-293-6892
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEPHEN PRESTON OLSON
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Credential | OTRL
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Telephone | 701-793-3646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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