Organization
NORTHSTAR CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY MELLUM DC (OWNDER)
(701) 429-7001
Entity
Organization
Contact information
Practice address
5621 36TH AVE S, SUITE 200, FARGO, ND 58104-5269
(701) 429-7001
Mailing address
5621 36TH AVE S, SUITE 200, FARGO, ND 58104-5269
(701) 429-7001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1039
ND
Other
Enumeration date
02/16/2017
Last updated
05/08/2017
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