Individual
WILLIAM KENT VISTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.R./L.
Contact information
Practice address
825 17TH AVE E, WEST FARGO, ND 58078-4274
(701) 356-2090
(701) 356-2099
Mailing address
7169 WOODLAND CIR, HORACE, ND 58047-4812
(701) 282-2377
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
539
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59797
—
ND
Enumeration date
03/17/2008
Last updated
03/17/2008
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