Individual
WILL W BAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4401 S 11TH ST, GRAND FORKS, ND 58201-7238
(701) 732-7570
Mailing address
4401 S 11TH ST, GRAND FORKS, ND 58201-7238
(701) 732-7570
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
758
ND
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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