Individual
LOWELL G LITTLE EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2403 E THAYER AVE, BISMARCK, ND 58501-5014
(701) 595-5181
Mailing address
2403 E THAYER AVE, BISMARCK, ND 58501-5014
(701) 595-5181
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
LIT558699
NC
172A00000X
Driver
Primary
LIT558699
ND
Other
Enumeration date
11/25/2022
Last updated
11/25/2022
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