Individual
JOHN EVENOCHECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13060 ISLE DR, BAXTER, MN 56425-8331
(188) 282-8802
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69227
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2019
Last updated
08/05/2022
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