Individual
JUSTIN CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7527 EPHRIAM HILL ROAD, FORT TOTTEN, ND 58335
(701) 766-4285
Mailing address
PO BOX 88, FORT TOTTEN, ND 58335-0088
(701) 766-4285
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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