Organization
LEGACY PRIMARY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI WILLIAMS (CRED SPEC)
(605) 846-8239
Entity
Organization
Contact information
Practice address
2100 S COLUMBIA RD STE 114, GRAND FORKS, ND 58201-5895
(701) 516-4637
(877) 651-1381
Mailing address
19580 SCOUT LN, SAINT ONGE, SD 57779-7913
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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