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JAN L WEATHERS PT;DPT

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1497138796

Individual Registrant:
 JAN L WEATHERS PT;DPT
Gender: F
Sole Proprietor

Location and contact information for practice:
602 MAIN ST E  MOHALL, ND 58761-4100 US
Tel: 701-756-6831  Fax: --

Contact information for business:
1991 94TH ST NW  MAXBASS, ND 58760-9722 US
Tel: 361-215-9914  Fax: --

Registration Information:
NPI: 1497138796
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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