Individual
JAMES MERLE GULLEKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4501 15TH AVE S STE 104, FARGO, ND 58103-8956
(701) 446-8833
Mailing address
4501 15TH AVE S STE 104, FARGO, ND 58103-8956
(701) 446-8833
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2014874
MN
163W00000X
Registered Nurse
R31784
ND
225700000X
Massage Therapist
Primary
22146
ND
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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