Individual
WESLEY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
701 DEMERS AVE STE B, GRAND FORKS, ND 58201-4506
(701) 772-2200
(701) 772-2800
Mailing address
1560 S CAROL ST, MERIDIAN, ID 83646-1839
(701) 772-2200
(701) 772-2800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT-10789
MN
225100000X
Physical Therapist
Primary
PT-2220
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-10789
STATE LICENSE
MN
01
—
PT-2220
STATE LICENSE
ND
Enumeration date
10/06/2017
Last updated
03/17/2018
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