Individual
DR. MARY PATRICIA TABBERSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
3220 18TH ST S, SUITE 2, FARGO, ND 58104-6564
(701) 234-0028
Mailing address
3220 18TH ST S, SUITE 2, FARGO, ND 58104-6564
(701) 234-0028
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
499
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16362
—
ND
Enumeration date
01/09/2007
Last updated
07/09/2007
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