Individual
JUSTIN EARL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5300 12TH ST S, FARGO, ND 58104-4034
(701) 346-0222
(701) 346-0223
Mailing address
642 12TH AVE E, WEST FARGO, ND 58078-3119
(218) 242-2845
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2388
ND
Other
Enumeration date
10/11/2019
Last updated
03/30/2023
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