is a Sports Medicine in Grand Forks, North Dakota. practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for is 1225080476. The last update date is .
's current location address is 3035 Demers Ave, Grand Forks, North Dakota. You can contact this provider via phone number 7017467521. The mailing address for is 3035 Demers Ave, Grand Forks, North Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 3035 Demers Ave, Grand Forks, North Dakota |
| Phone Number | 7017467521 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1225080476 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 3035 Demers Ave |
|---|---|
| City | Grand Forks |
| State | North Dakota (ND) |
| Post Code | 582014040 |
| Phone Number | 7017467521 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 829560001 | MI | MEDICARE DME | |
| 104727842 | MI | -- | |
| 0C16002 | MI | MEDICARE GROUP | |
| DL084882 | MI | BLUECROSS STATE ID |
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