Individual
WAYNE BARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 2ND AVE W, WILLISTON, ND 58801-4108
(701) 572-6766
Mailing address
406 15TH AVE W, WILLISTON, ND 58801-4508
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
859
ND
Other
Enumeration date
06/21/2013
Last updated
06/21/2013
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