Individual
ROSE MICHELLE BURCHAM-LAFOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 1ST ST SE LOT 19, MANDAN, ND 58554-4481
(701) 550-9854
Mailing address
PO BOX 904, MANDAN, ND 58554-0904
(701) 550-9854
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
69350
ND
Other
Enumeration date
09/25/2021
Last updated
09/25/2021
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