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Organization

PROXIMAL 50, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANA TROTTER PT, DPT (PHYSICAL THERAPIST)
(701) 260-2693
Entity
Organization

Contact information

Practice address
1151 W. DIVIDE AVE, BISMARCK, ND 58501
(701) 751-7797
Mailing address
1151 W. DIVIDE AVE, BISMARCK, ND 58501
(701) 751-7797

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1964
ND

Other

Enumeration date
07/21/2015
Last updated
07/22/2015
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