Individual
CLYDE VINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1415 W DAKOTA PKWY, WILLISTON, ND 58801-3885
(701) 572-6757
(701) 774-3532
Mailing address
1213 KNOLL ST, WILLISTON, ND 58801-3234
(701) 572-8083
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
669
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50824
—
ND
Enumeration date
02/15/2007
Last updated
07/09/2007
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