Organization
LIVING WELL DAKOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY TANNER PA-C (PROVIDER)
(701) 989-8251
Entity
Organization
Contact information
Practice address
1140 W CAPITOL AVE, BISMARCK, ND 58501-1306
(701) 989-8251
Mailing address
6612 DAKOTA COUNTRY DR, BISMARCK, ND 58503-1550
(701) 989-8251
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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