Individual
SHIRLEY KULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 234-8730
(701) 417-6232
Mailing address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 234-8730
(701) 417-6232
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
123
ND
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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