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Individual

CHERRON MARIE KINGZETT HALVORSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
42 6TH AVE SE, MAYVILLE, ND 58257-1506
(701) 788-4439
Mailing address
550 32ND ST NE, NORTHWOOD, ND 58267-9525
(218) 791-6291

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1557
ND
225100000X
Physical Therapist
7574
MN

Other

Enumeration date
03/23/2007
Last updated
04/19/2011
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