Individual
ELIZABETH DEBRA MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
818 10TH AVE N, FARGO, ND 58102-3638
(708) 603-3026
Mailing address
818 10TH AVE N, FARGO, ND 58102-3638
(708) 603-3026
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/03/2018
Last updated
07/03/2020
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