Individual
KARI IDSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5608
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5608
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
642
ND
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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