Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-09-21
- Last updated
- 2020-01-24
Licenses
- License ND
- 5025
Location
- Practice location
- 1000 HIGHWAY 12
- City
- HETTINGER ND
- Postal code
- 586397530
- Phone
- 701-567-4561
Organization contact
- Name
- NATHAN STADHEIM
- Title
- Chief Financial Officer
- Phone
- 7015676150
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.