Organization
BACHNDOC INC.
Active
Other names
Lifeways
Organization subpart
No
Provider details
NPI number
Authorized official
JASON DEAN DOCKTER BUSINESS OWNER (MANAGER)
(701) 258-9848
Entity
Organization
Contact information
Practice address
1001 GATEWAY AVENUE, BISMARCK, ND 58503
(701) 751-3271
Mailing address
1001 GATEWAY AVENUE, BISMARCK, ND 58503
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13425
—
ND
05
—
19837
—
ND
Enumeration date
05/10/2006
Last updated
02/08/2010
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