Individual
KHYLLE PELMYR ALABANZAS PEPINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 651-1273
Mailing address
320 18TH ST E, WILLISTON, ND 58801-4366
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTP-PT-LIC-24686
MT
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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