Individual
AMY IBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1237 W DIVIDE AVE STE 5, BISMARCK, ND 58501-1208
(701) 328-8851
Mailing address
1237 W DIVIDE AVE STE 5, BISMARCK, ND 58501-1208
(701) 328-8851
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/27/2021
Last updated
07/29/2021
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