Organization
FOUNDATIONS MENTAL HEALTH CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN WIEDMANN PA-C (OWNER)
(701) 543-5533
Entity
Organization
Contact information
Practice address
4040 42ND ST S STE N, FARGO, ND 58104-4352
(701) 388-5825
Mailing address
4040 42ND ST S STE N, FARGO, ND 58104-4352
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/06/2024
Last updated
12/05/2024
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