Legacy Medical LLC
NPI #1619594637 in Bismarck, North Dakota
Provider Information
- NPI Number
- 1619594637
- Entity Type
- Organization
- Organization Name
- Legacy Medical LLC
- Primary Specialty
- Family Medicine - Adult Medicine
- Enumeration Date
- Jun 26, 2020
- Last Updated
- Mar 3, 2023
Practice Location
- Address
- 600 S 2ND ST STE 200
- City
- Bismarck
- State
- North Dakota
- ZIP Code
- 58504-5729
- Phone
- (701) 516-4637
Authorized Official
- Name
- JILL WILSON, MBA, OTR/L
- Title
- CHIEF OPERATING OFFICER
- Phone
- (701) 516-4637
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Adult Medicine — Adult Medicine |
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