Individual
BRIAN ILLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-2000
Mailing address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-2000
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2500
ND
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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