Spirit Lake Tribe

NPI #1417408907 in Fort Totten, North Dakota

Provider Information

NPI Number: 1417408907
Entity Type: Organization
Organization Name: Spirit Lake Tribe
Subpart: Yes (part of a larger organization)
Parent Organization: SPIRIT LAKE TRIBE
Primary Specialty: Optometrist
Enumeration Date: Oct 19, 2016
Last Updated: Oct 19, 2016

Practice Location

Address: 3883 74TH AVE NE
City: Fort Totten
State: North Dakota
ZIP Code: 58335
Phone: (701) 766-1600

Authorized Official

Name: MICHELLE BELT
Title: CEO
Phone: (701) 766-1600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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