Individual
JESSICA WALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 S 11TH ST, GRAND FORKS, ND 58201-7238
(701) 732-7570
Mailing address
3165 DEMERS AVE, GRAND FORKS, ND 58201-4049
(701) 780-6623
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1136
ND
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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