Individual
SAMANTHA KIECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1207 PRAIRIE PKWY, WEST FARGO, ND 58078
(701) 492-0696
(701) 492-0696
Mailing address
1207 PRAIRIE PKWY, WEST FARGO, ND 58078-3145
(701) 492-0696
(701) 492-0696
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
894
ND
Other
Enumeration date
12/05/2011
Last updated
07/24/2014
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