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Individual

DR. NICHOLE BLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
126 S MAIN AVE, RUGBY, ND 58368-1733
(701) 776-5800
Mailing address
720 20TH AVE SW, MINOT, ND 58701-6441
(701) 838-8000
(701) 838-8444

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
992
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10644
ND
01
18476
MEDICAID GROUP NUMBER
ND
01
N711351
MEDICARE PTAN
ND
Enumeration date
01/15/2015
Last updated
02/19/2016
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