Individual
EVAN MARTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
736 BROADWAY N, FARGO, ND 58102-4421
(701) 234-2000
Mailing address
5851 58TH AVE S, FARGO, ND 58104-5705
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1991
ND
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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