Individual
MICHAEL LT GBOLOKAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4924 47TH ST S APT 106, FARGO, ND 58104-4418
(701) 491-0103
Mailing address
4924 47TH ST S APT 106, FARGO, ND 58104-4418
(701) 491-0103
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
57933
ND
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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