Organization
SOURIS VALLEY SPECIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY HALVORSON (BUSINESS MANAGER)
(701) 857-4411
Entity
Organization
Contact information
Practice address
215 2ND ST SE, MINOT, ND 58701-3924
(701) 857-4410
(701) 857-4413
Mailing address
215 2ND ST SE, MINOT, ND 58701-3924
(701) 857-4410
(701) 857-4413
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1106
ND
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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