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Individual

MR. CHARLES THOMAS LANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
1720 UNIVERSITY S, SANFORD HEALTH, FARGO, ND 58103
(701) 417-4137
Mailing address
4 BIRCH LN S, FARGO, ND 58103-4606
(701) 749-2385

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
103000
MN
225X00000X
Occupational Therapist
111398
TX
225X00000X
Occupational Therapist
Primary
1203
ND
225X00000X
Occupational Therapist
2485
AL
225X00000X
Occupational Therapist
3837
AZ

Other

Enumeration date
05/13/2007
Last updated
10/03/2014
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