Individual
JOHN R SHILLING JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
3902 13TH AVE S, FARGO, ND 58103-3357
(701) 364-6600
(701) 364-6628
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-6600
(701) 364-6628
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0431
ND
Other
Enumeration date
07/14/2010
Last updated
12/29/2011
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