Individual provider · NPI-1

Jonathan Dandurand

Student in an Organized Health Care Education/Training Program · Fargo, ND

NPI number1134584410
StatusActive
Last updated in NPPESDec 30, 2015

Details

NPI
1134584410
Entity type
Individual (NPI-1)
Name
Jonathan Dandurand
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 30, 2015
Last updated
Dec 30, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes
2255A2300X Specialist/Technologist, Athletic Trainer––

Practice location

905 5th St N Apt 31
Fargo, ND 58102-3771

Phone 701-793-0135

Mailing address

905 5th St N Apt 31
Fargo, ND 58102-3771

Phone 701-793-0135

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