Organization
MERITCARE HEALTH SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANNE NECHIPORENKO O.T. (SPORTS MEDICINE MANAGER)
(701) 234-7770
Entity
Organization
Contact information
Practice address
2300 4TH AVE S, MOORHEAD, MN 56560-3269
(218) 284-2412
(218) 284-2347
Mailing address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-8700
(701) 234-7961
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1557
MN
Other
Enumeration date
09/16/2006
Last updated
08/22/2020
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