Organization
DESTINY MED SPA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA CLAIR (DIRECTOR/PRACTICE MANAGER)
(701) 354-9200
Entity
Organization
Contact information
Practice address
1415 W DAKOTA PKWY STE 3B, WILLISTON, ND 58801-3885
(701) 354-9200
Mailing address
1415 W DAKOTA PKWY STE 3B, WILLISTON, ND 58801-3885
(701) 354-9200
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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