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Individual

LOLA ANNA BROWN I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
122 DAKOTA AVE N, MADDOCK, ND 58348-7200
(701) 351-1594
Mailing address
122 DAKOTA AVE N, MADDOCK, ND 58348-7200
(701) 351-1594

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1451575
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1451575
ND
Enumeration date
11/20/2020
Last updated
11/20/2020
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