Provider Information for 1164823316
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BRIDGET MERANDA
Sex: Female
NPI: 1164823316
Last Updated: 2014-09-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1164823316 | ||||||||
| Enumeration Date | 2014-09-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 5196 GRAND FORKS, ND 58206-5196 United States Phone: 701-787-8540 | Fax:701-787-5918 | ||||||||
| Primary Practice Address | 151 S 4TH ST SUITE 201 GRAND FORKS, ND 58201-4715 United States Phone: 701-787-8540 | Fax:701-787-5918 | ||||||||
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