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Individual

TYLER VENJOHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4118 SELKIRK RD, BISMARCK, ND 58503-8291
(701) 426-0742
Mailing address
4118 SELKIRK RD, BISMARCK, ND 58503-8291
(701) 426-0742

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1451
ND

Other

Enumeration date
02/26/2016
Last updated
02/26/2016
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