Individual
JEFFREY L WOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 280-2212
(701) 271-1023
Mailing address
2301 25TH ST S, FARGO, ND 58103-6104
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
473
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00062409
RAILROAD MEDICARE
ND
Enumeration date
06/22/2006
Last updated
01/31/2008
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