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Individual

LESLIE RAE HELLEBUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
204 W CENTURY AVE, BISMARCK, ND 58503-1494
(701) 255-0186
Mailing address
204 W CENTURY AVE, BISMARCK, ND 58503-1494
(701) 255-0186

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
707
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619317724
BCBS OF ND
ND
05
60725
ND
Enumeration date
07/03/2013
Last updated
01/02/2015
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