Individual
JACK K HARTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 3RD ST NW, JAMESTOWN, ND 58401-2968
(701) 253-6300
Mailing address
520 3RD ST NW, JAMESTOWN, ND 58401-2968
(701) 253-6300
(701) 253-6400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1034-10-1-19A
ND
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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