Individual
AUDREY EVANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
416 MAIN ST, LISBON, ND 58054-4142
(701) 680-9167
Mailing address
14061 62 1/2 ST SE, LISBON, ND 58054-9421
(701) 680-9167
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1729
ND
Other
Enumeration date
04/26/2017
Last updated
04/26/2017
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