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Carole Joann Stanger

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NPI Number Detailed Information

Provider Information:

Name: Carole Joann Stanger
Gender: F
Provider License Number If Given: R1339738

NPI Information:

NPI: 1629062138
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 1/13/2009

Provider Business Mailing Address:

Address: 304 4TH ST SE
Hillsboro, ND 58045
Phone Number: 7016364751
Fax Number:

Provider Business Practice Location Address:

Address: 920 2ND AVE S
Minneapolis, MN 55402
Phone Number: 6126597101
Fax Number:

Provider Taxonomy:

Primary: 363LF0000X
Secondary (if any):
State: MN

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