Individual
RAE ELLEN MATHEWS-HALMRAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 280-2212
(701) 271-1023
Mailing address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 280-2212
(701) 271-1023
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
297
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51245
—
ND
Enumeration date
09/26/2006
Last updated
10/01/2007
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