Individual
MISS KATHLEEN YVETTE GALLAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC, NREMT
Contact information
Practice address
1300 17TH AVE N, FARGO, ND 58102
(701) 231-6378
Mailing address
3839 30TH AVE S APT 301, FARGO, ND 58104-7755
(701) 630-2846
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
E3446979
ND
2255A2300X
Athletic Trainer
Primary
808-18
ND
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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