Individual
MATT BAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1461 BROADWAY N, FARGO, ND 58102-2622
(701) 293-6037
Mailing address
2620 41ST ST S APT 310, FARGO, ND 58104-9161
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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