Individual
DR. ANTHONY HEATH CHARBONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
736 BROADWAY N, FARGO, ND 58122
(701) 234-6735
Mailing address
4740 TIMBER PKWY S APT 312, FARGO, ND 58104-4823
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1963
ND
2251X0800X
Orthopedic Physical Therapist
Primary
1963
ND
Other
Enumeration date
08/22/2017
Last updated
06/21/2019
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