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Individual

JASON W ZACHARIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
1200 S COLUMBIA RD, GRAND FORKS, ND 58201-4036
(701) 780-5000
Mailing address
1200 S COLUMBIA RD, GRAND FORKS, ND 58201-4036
(701) 780-5000

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
104487
MN
225X00000X
Occupational Therapist
Primary
1479
ND

Other

Enumeration date
06/27/2013
Last updated
06/30/2016
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