Organization
GILLETTE FAMILY CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRIN S GILLETTE DC (OWNER)
(701) 237-4010
Entity
Organization
Contact information
Practice address
825 25TH ST S, FARGO, ND 58103-8724
(701) 237-4010
(701) 237-5150
Mailing address
825 25TH ST S, FARGO, ND 58103-8724
(701) 237-4010
(701) 237-5150
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
672
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11052
—
ND
01
—
13D48GI
BLUE CROSS BLUE SHIELD OF MN
—
01
—
GIL18266
BLUE CROSS BLUE SHIELD OF ND
ND
Enumeration date
01/14/2015
Last updated
01/20/2015
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