Individual
TREVOR LEE UMPLEBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 6TH AVE SW, MANDAN, ND 58554-4013
(701) 590-5138
Mailing address
300 6TH AVE SW, MANDAN, ND 58554-4013
(701) 590-5138
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
1477011
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477011
—
ND
Enumeration date
10/12/2020
Last updated
10/12/2020
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