Individual
KYLE CLEASBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1919 ELM ST N, FARGO, ND 58102-2416
(701) 293-4113
(701) 293-4109
Mailing address
1463 I94 BUSINESS LOOP E, DICKINSON, ND 58601-6434
(701) 227-7500
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
18990
ND
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
01/23/2023
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