Individual
MICHAEL VILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
5627 S 11TH ST, GRAND FORKS, ND 58201-3632
(701) 330-4510
Mailing address
5627 S 11TH ST, GRAND FORKS, ND 58201-3632
(701) 330-4510
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
1497513931
—
Other
Enumeration date
03/11/2024
Last updated
05/01/2024
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