Organization
SUEDEL THERAPEUTICS PLLC
Active
Other names
Suedel Therapeutics & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE SUEDEL OT (AUTHORIZED OFFICIAL)
(701) 317-2897
Entity
Organization
Contact information
Practice address
3535 S 31ST ST STE 105, GRAND FORKS, ND 58201-3592
(701) 317-2897
(701) 213-4345
Mailing address
1311 S WASHINGTON ST, GRAND FORKS, ND 58201-5406
(701) 317-2897
(701) 213-4345
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SUE78-1717
DRIVERS LICENSE
ND
Enumeration date
01/14/2020
Last updated
10/18/2022
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