# SUEDEL THERAPEUTICS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Suedel Therapeutics & Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902446271
- **Authorized official:** STEPHANIE SUEDEL OT (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (701) 317-2897

## Contact information

- **Practice address:** 3535 S 31ST ST STE 105, GRAND FORKS, ND 58201-3592
- **Practice address phone:** (701) 317-2897
- **Practice address fax:** (701) 213-4345
- **Mailing address:** 1311 S WASHINGTON ST, GRAND FORKS, ND 58201-5406
- **Mailing address phone:** (701) 317-2897
- **Mailing address fax:** (701) 213-4345

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 01/14/2020
- **Last updated:** 10/18/2022