Individual
ALEXIS JADE JOHNSRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
200 8TH ST NE, WATFORD CITY, ND 58854-7532
(701) 842-6307
Mailing address
200 8TH ST NE, WATFORD CITY, ND 58854-7532
(701) 842-6307
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1468
ND
Other
Enumeration date
04/06/2016
Last updated
04/06/2016
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