Individual
MASON WARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 ROBERTS ST N, FARGO, ND 58102-4716
(701) 404-9180
Mailing address
4905 38TH AVE S, FARGO, ND 58104-8513
(701) 404-9180
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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