Individual
SUSAN K FALCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4036
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-4036
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0180
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71057
—
ND
Enumeration date
09/27/2006
Last updated
10/16/2012
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