Organization
BURCKHARD CLINIC, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE V. BURCKHARD LICSW (CLINICAL DIRECTOR)
(701) 852-5876
Entity
Organization
Contact information
Practice address
315 MAIN ST S STE 315, STE. 315, MINOT, ND 58701-3956
(701) 852-5876
(701) 852-5883
Mailing address
315 MAIN ST S STE 315, STE. 315, MINOT, ND 58701-3956
(701) 852-5876
(701) 852-5883
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
120
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11482
—
ND
Enumeration date
12/22/2006
Last updated
11/19/2014
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