Individual
CANDACE MARIE VANDER WAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC, CSCS
Contact information
Practice address
3451 N 14TH ST STE C, BISMARCK, ND 58503-1611
(701) 323-1125
Mailing address
3451 N 14TH ST STE C, BISMARCK, ND 58503-1611
(701) 323-1125
(701) 323-1180
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
683-15
ND
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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