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Organization

COMPREHENSIVE PEDIATRIC CARE, P. C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLEN W FINLEY (ADMINISTRATOR)
(701) 572-7732
Entity
Organization

Contact information

Practice address
1411 W DAKOTA PKWY STE 2A, WILLISTON, ND 58801-3854
(701) 572-7732
(701) 572-7997
Mailing address
PO BOX 696, WILLISTON, ND 58802-0696
(701) 572-7732
(701) 572-7997

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05412001
BLUE SHIELD
ND
05
12772
ND
Enumeration date
11/07/2006
Last updated
06/16/2009
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