Individual
STEPHEN V. CISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5255 CENTER AVE, GRAND FORKS, ND 58203-2621
(701) 610-3444
Mailing address
5255 CENTER AVE, GRAND FORKS, ND 58203-2621
(701) 772-0950
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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