Organization
FARGO CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA F DAVIS DC & ACUPUNTURIST (OWNER)
(701) 232-4922
Entity
Organization
Contact information
Practice address
1515 S UNIVERSITY DRIVE, FARGO, ND 58103
(701) 232-4922
Mailing address
1515 S UNIVERSITY DRIVE, FARGO, ND 58103
(701) 232-4922
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
437
ND
171100000X
Acupuncturist
437
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15199
—
ND
01
—
4328
BLUE CROSS BLUE SHIELD
ND
Enumeration date
12/05/2006
Last updated
12/04/2007
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