Individual
SHARI LYN KENSOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3051 25TH ST S, STE K-2, FARGO, ND 58103
(701) 234-0766
(701) 234-0769
Mailing address
3051 25TH ST S, STE K-2, FARGO, ND 58103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2313
MN
152W00000X
Optometrist
Primary
493
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60421
—
ND
Enumeration date
09/15/2006
Last updated
07/08/2007
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