Individual
ILEA CHARLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 4TH ST SW, WATFORD CITY, ND 58854-7146
(701) 690-5956
Mailing address
PO BOX 1614, WATFORD CITY, ND 58854-1614
(701) 690-5956
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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