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Organization
MILESTONE THERAPEUTICS INC
Active
Organization
MILESTONE THERAPEUTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN PRESTON OLSON OTRL (PRESIDENT)
(701) 793-3646
Entity
Organization
Contact information
Practice address
921 43RD AVE N, FARGO, ND 58102-5320
(701) 793-3646
(701) 293-6892
Mailing address
921 43RD AVE N, FARGO, ND 58102-5320
(701) 793-3646
(701) 293-6892
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1042648
PREFERRED ONE PROV. NUM.
ND
01
—
107041
HEALTH PARTNERS PROV. #
ND
01
—
371G1MI
BCBS MN PROVIDER NUMBER
MN
01
—
371G1MI
EPNI PROVIDER NUMBER
ND
01
—
54893
ND MA PROVIDER NUMBER
ND
01
—
6345001
BCBS ND CLINIC NUMBER
ND
01
—
64-05519
MEDICA PROVIDER NUMBER
ND
Enumeration date
01/07/2007
Last updated
08/22/2020
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