Individual
THEO ATLAS FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
3001 HARVEST HILLS DR APT 315, WILLISTON, ND 58801-2670
(701) 705-0868
Mailing address
3001 HARVEST HILLS DR APT 315, WILLISTON, ND 58801-2670
(701) 705-0868
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2022
Last updated
07/28/2025
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