Individual
LAN SIVERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1817 16TH AVE S, MOORHEAD, MN 56560-4702
(218) 790-4374
Mailing address
1817 16TH AVE S, MOORHEAD, MN 56560-4702
(218) 790-4374
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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