Individual
KAL DATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 S 4TH ST STE 111, GRAND FORKS, ND 58201-4792
(701) 260-5895
Mailing address
311 S 4TH ST STE 111, GRAND FORKS, ND 58201-4792
(701) 260-5895
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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