Individual
MRS. NICOLE MARIE FOLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1461 BROADWAY N, FARGO, ND 58102-2622
(701) 293-6037
(701) 293-0242
Mailing address
1461 BROADWAY N, FARGO, ND 58102-2622
(701) 293-6037
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1269A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1269A
NORTH DAKOTA BOARD OF PHYSICAL THERAPY
ND
Enumeration date
10/30/2018
Last updated
10/30/2018
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