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22 Wiley Ave., Lidgerwood, ND 58053-0087 | |
(701) 538-4114 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 22 Wiley Ave., Lidgerwood, North Dakota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1265789150 | NPI | - | NPPES |
16756 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 872 (North Dakota) | Primary |
Provider Name | Breanna N Bischoff |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1962706184 PECOS PAC ID: 7810148129 Enrollment ID: I20121114000642 |
Mailing Address | Practice Location Address |
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22 Wiley Ave, Po Box 87, Lidgerwood, ND 58081-0087 Ph: (701) 538-4114 | 22 Wiley Ave., Lidgerwood, ND 58053-0087 Ph: (701) 538-4114 |
Dr. Breanna Noelle Bischoff, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 22 Wiley Ave., Lidgerwood, ND 58053 Phone: 701-538-4114 |