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Individual

KEVIN RAY FORDERER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
13801 10TH AVE SE, BISMARCK, ND 58504-3827
(701) 527-2282
Mailing address
13801 10TH AVE SE, BISMARCK, ND 58504-3827
(701) 527-2282

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Enumeration date
10/25/2020
Last updated
11/09/2020
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