Individual
TAYLOR VISTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 5TH AVE NE, DEVILS LAKE, ND 58301-1934
(701) 739-6262
Mailing address
1220 5TH AVE NE, DEVILS LAKE, ND 58301-1934
(701) 739-6262
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
ND
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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