Individual
LACEY JUELFS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
12 6TH AVE SW, PO BOX C, BOWMAN, ND 58623-4518
(701) 523-3226
Mailing address
12 6TH AVE SW, PO BOX C, BOWMAN, ND 58623-4518
(701) 523-3226
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1056
ND
Other
Enumeration date
12/21/2015
Last updated
12/21/2015
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