Individual
GREGORY DON CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
151 S 4TH ST, SUITE 401, GRAND FORKS, ND 58201-4715
(701) 795-3000
(701) 795-3084
Mailing address
151 S 4TH ST, SUITE 401, GRAND FORKS, ND 58201-4715
(701) 795-3000
(701) 795-3084
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054519
—
NC
Enumeration date
04/25/2007
Last updated
07/09/2007
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