Blue Water Therapy, LLC
NPI #1245475797 in Fargo, North Dakota
Provider Information
- NPI Number
- 1245475797
- Entity Type
- Organization
- Organization Name
- Blue Water Therapy, LLC
- Primary Specialty
- Clinic/Center - Rehabilitation
- Enumeration Date
- Dec 12, 2008
- Last Updated
- Dec 12, 2008
Practice Location
- Address
- 3321 4TH AVE S STE D
- City
- Fargo
- State
- North Dakota
- ZIP Code
- 58103-2235
- Phone
- (701) 200-8181
Authorized Official
- Name
- GABRIEL THOMAS EVENSON, MOTR/L
- Title
- PRESIDENT
- Phone
- (701) 200-8181
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation — Rehabilitation |
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