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Individual

MR. JERRY WENDEL DAUB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1326 25TH ST S, FARGO, ND 58103-3629
(701) 371-2225
Mailing address
1326 25TH ST S, FARGO, ND 58103-3629
(701) 371-2225

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
480
ND

Other

Enumeration date
03/01/2021
Last updated
03/01/2021
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