Individual
BRANDI BOULDUC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
930 N 3RD ST, GRAND FORKS, ND 58203-2408
(701) 795-9143
Mailing address
930 N 3RD ST, GRAND FORKS, ND 58203-2408
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
10602
—
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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