Individual
KELLEN ELAINE PATHROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1221 W DIVIDE AVE, BISMARCK, ND 58501-1224
(701) 224-0661
Mailing address
1221 W DIVIDE AVE, BISMARCK, ND 58501-1224
(701) 224-0661
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
713
ND
Other
Enumeration date
07/05/2013
Last updated
10/03/2013
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