Organization
OMDALEN CHIROPRACTIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT EDWARD OMDALEN D.C. (OWNER)
(701) 786-4024
Entity
Organization
Contact information
Practice address
45 1ST AVE SE, MAYVILLE, ND 58257
(701) 786-4024
(701) 786-4034
Mailing address
45 1ST AVE SE, MAYVILLE, ND 58257
(701) 786-4024
(701) 786-4034
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01210001
BS GROUP
ND
05
—
16235
—
ND
Enumeration date
03/20/2007
Last updated
08/22/2020
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