Organization
FOUR SEASONS WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY KAYE RATH FNPC (FAMILY NURSE PRACTITIONER)
(701) 475-4488
Entity
Organization
Contact information
Practice address
110 W BROADWAY, STEELE, ND 58482-7109
(701) 475-4488
(701) 540-6379
Mailing address
110 W BROADWAY, PO BOX 397, STEELE, ND 58482-7109
(701) 475-4488
(701) 540-6379
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
R28545
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386964138
—
ND
Enumeration date
10/13/2016
Last updated
02/01/2017
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