Individual
NICHOL K DILLAVOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1325 57TH AVE NE, BISMARCK, ND 58503-6581
(701) 471-0465
(701) 712-5662
Mailing address
1325 57TH AVE NE, BISMARCK, ND 58503-6581
(701) 471-0465
(701) 712-5662
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
591
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60566
—
ND
Enumeration date
08/30/2006
Last updated
04/28/2025
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