Individual
MICHAEL VANDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 MAIN AVE E, ROLLA, ND 58367-7124
(701) 477-9053
Mailing address
PO BOX 841, BELCOURT, ND 58316-0841
(701) 550-0797
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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