Individual
MRS. ANASTASIA VICKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
613 23RD AVE NW, MINOT, ND 58703-0930
(701) 240-5626
Mailing address
613 23RD AVE NW, MINOT, ND 58703-0930
(701) 240-5626
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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