Individual
JODI KILEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
631 4TH AVE EAST, WEST FARGO, ND 58078
(701) 356-2010
Mailing address
509 MAIN ST, ABERCROMBIE, ND 58001-0024
(701) 238-1471
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
KILEN24
—
ND
Enumeration date
05/04/2016
Last updated
05/04/2016
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