Individual
MISS MICHELLE LYNN GOULET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
206 N 19TH ST, BISMARCK, ND 58501-4746
(701) 224-9436
Mailing address
206 N 19TH ST, BISMARCK, ND 58501-4746
(701) 224-9436
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
976
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
976
NORTH DAKOTA BOARD OF MASSAGE
ND
Enumeration date
02/08/2011
Last updated
02/08/2011
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