Individual
KISI YAVECIA BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3332 8TH ST NE, MINOT, ND 58703-2610
(701) 770-0886
Mailing address
3332 8TH ST NE, MINOT, ND 58703-2610
(701) 770-0886
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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