Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 308 5th Ave, Marion, 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 |
---|---|---|---|
1073163176 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Mandi Miedema |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1003056961 PECOS PAC ID: 5193904399 Enrollment ID: I20200322000193 |
Provider Name | Stephen P Kutscher |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1285964593 PECOS PAC ID: 0749469955 Enrollment ID: I20221111001652 |
Provider Name | Edison M Arauz |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1407567613 PECOS PAC ID: 8022489681 Enrollment ID: I20230119000997 |
Mailing Address | Practice Location Address |
---|---|
5135 101st Ave Se, Marion, ND 58466-9643 Ph: (701) 830-0431 | 308 5th Ave, Marion, ND 58466 Ph: (701) 830-0431 |